目的：用Meta分析方法评估骨代谢标志物血清⁃NTx（Ⅰ型胶原交联氨基末端肽）对肺癌乳腺癌患者骨转移诊断和预后的价值。方法利用计算机检索PubMed、Cochrane Library、EMBase、中国知网、万方和维普等数据库，收集涉及骨代谢标志物血清⁃NTx肺癌乳腺癌患者骨转移诊断及预后的临床研究，按文献纳入排除标准筛选文献，评价文献质量，提取数据资料，应用Stata 12�0软件进行Meta分析。结果共纳入文献11篇，其中英文文献6篇，中文文献5篇，有关NTx对肺癌乳腺癌骨转移诊断研究8篇，预后研究2篇，1篇文献同时涉及诊断与预后的研究。共计1203例研究对象，肺癌患者726例，乳腺癌患者372例。诊断骨转移：合并灵敏度为76�5％（95％CI：61�5％～86�9％），合并特异度为83�3％（95％CI：77�1％～88�1％）；总生存期的风险比（HR）：初治高血清⁃NTx者与低血清⁃NTx者比较，合并 HR＝1�208（95％CI：1�128～1�293，P＜0�05）。结论 NTx对肺癌乳腺癌患者诊断骨转移和评估预后具有较高的临床价值。%Objective To assess the value of serum crosslinked N⁃telopeptide of type I collagen ( NTx) in the diagnosis of bone metastasis and prognosis of lung cancer and breast cancer. Methods PubMed, Cochrane Library, EMBase, CNKI, Wanfang da⁃tabase and VIP database were searched for collecting retrospective studies on serum NTx for diagnosis and prognosis of lung cancer and breast cancer. Studies were screened by the inclusion and exclusion criteria. QUADAS was used to evaluate the quality of the diagnostic studies. Stata 12�0 software was used to conduct the meta⁃analysis. Results Eleven literatures were selected, including 6 literatures in English and the others in Chinese, 8 studies about diagnosis, 2 studies about prognosis, and 1 study including diagnosis and prognosis were selected. A total of 1203 cases were identified, including 726 cases of lung cancer and 372 cases of breast cancer. The sensitivity and specificity of serum NTx in the diagnosis of bone metastasis from lung cancer and breast cancer were 76�5 % ( 95%CI: 61�5%⁃86�9%) and 83�3% ( 95%CI: 77�1%⁃88�1%) , respectively. Merger HR estimate of overall survival for lung cancer and breast cancer patients with high serum NTx was 1�208 ( 95%CI:1�128⁃1�293, P<0�05) . Conclusion Despite the limitations of this study, serum NTx is a potential biomarker to detect bone metastasis and predict outcome in lung cancer and breast cancer. More prospective studies are necessary to analyze the clinical significance of serum NTx further.
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