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目的系统评价血清标志物间皮素在卵巢癌中的诊断价值。方法计算机检索Pub Med、Web of Science、The Cochrane Library、CBM、CNKI和Wan Fang Data数据库,搜集间皮素诊断卵巢癌的诊断性试验,检索时限从建库至2016年10月。由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用MetaDi Sc 1.4、Stata 12和Rev Man 5.2软件进行统计分析,计算其合并敏感度(Sen_合并)、特异性(Spe合并)、诊断比值比(DOR),绘制汇总受试者工作特征(SROC)曲线并计算曲线下面积(AUC)。结果共纳入17个研究,包括2 052例患者。Meta分析结果显示:间皮素诊断卵巢癌的Sen_合并、Spe_合并、DOR分别为0.63[95%(0.60,0.67)]、0.92[95%(0.90,0.93)]、26.62[95%(14.96,47.38)],AUC和Q指数分别为0.915 1和0.847 8。结论当前证据显示,间皮素诊断卵巢癌特异性较高而敏感度较低,不能单独作为生物标志物用于卵巢癌的检测,应与其它标志物进行联合检测。
Objective To evaluate the diagnostic value of serum marker mesothelin in ovarian cancer. Methods The databases of Pub Med, Web of Science, The Cochrane Library, CBM, CNKI and Wan Fang Data were searched by computer, and the diagnostic test of mesothelin in the diagnosis of ovarian cancer was collected. The search time was from the database to October 2016. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the inclusion study. MetaDi Sc 1.4, Stata 12, and Rev Man 5.2 software were used for statistical analysis to calculate the combined sensitivity (Sen_), specificity Spe combined), diagnostic odds ratio (DOR), draw summary SERT curve and calculate area under the curve (AUC). Results A total of 17 studies were included, including 2,052 patients. Meta-analysis showed that the values of Sen_, Spe_ and DOR of mesothelin in diagnosing ovarian cancer were 0.63 [95% (0.60,0.67)], 0.92 [95% (0.90,0.93)], 26.62 [95% 14.96, 47.38)], the AUC and Q indices were 0.915 1 and 0.847 8, respectively. Conclusions The current evidence shows that mesothelin is more specific and less sensitive in the diagnosis of ovarian cancer and can not be used alone as a biomarker for the detection of ovarian cancer. It should be jointly tested with other markers.