联合检测 CA125与 HE4对卵巢癌诊断价值的 Meta 分析

摘要

目的：评述联合检测糖类抗原125（ CA125）与人附睾蛋白4（ HE4）在卵巢癌诊断中的价值。方法计算机检索PubMed、CNKI、维普等数据库。收集自建库至2015-02有关卵巢癌诊断中联合检测CA125与HE4的文献。采用Stata 12.0进行Meta分析。结果11篇文献符合纳入标准，其中卵巢癌病例组为834例，正常或非卵巢癌病例对照组为1784例。各研究之间存在差异性，按照随机效应模型计算， CA125单独检测及CA125联合HE4检测，对卵巢癌的汇总灵敏度、阴性似然比、诊断比值比（ DOR ）分别为0.72[95％CI （0.65，0.78）]与0.89[95％CI（0.85，0.92）]，0.35[95％CI（0.27，0.46）]与0.13[95％CI（0.09，0.18）]，10 ；[95％CI（5，19）]与44[95％CI（28，71）]。两种检测方式的诊断效能比较差异有统计学意义（P＜0.05）。结论卵巢癌的临床辅助诊断中，与单独检测CA125比较，联合检测CA125、HE4的判别能力强，准确率较高，可提高诊断效能。%Objective To evaluate the importance of combined detection of tumor markers CA 125 and HE4 in the diagnosis of ovarian cancer .Methods The digital literatures were retrieved from the databases of PubMed , CNKI and VIP to evaluate the significance of the combined detection of the tumor markers CA 125 and HE4 in the di-agnosis of ovarian cancer .Stata 12.0 software was used to conduct the Meta-analysis.Results A total of 11 litera-tures were obtained in the current work with 834 ovarian cancer cases and 1 784 controls.The result showed that the sensitivity, specificity and diagnostic odds ratio(DOR) index of the tumor markers CA125 and HE4 were 0.89[95%CI(0.85,0.92)], 0.13[95%CI(0.09,0.18)] and 44[95%CI(28,71)] respectively in the combined detection of tumor markers CA125 and HE4, while the indices of the sensitivity, specificity, diagnostic odds ratio(DOR) of the marker CA125 that was detected alone were 0.72[95%CI(0.65,0.78)], 0.35 [95%CI(0.27,0.46)] and 10 [95%CI(5,19)] respectively.There were significant differences between the two methods in diagnosing ovarian cancer.Conclusion The combined detection of the tumor markers CA 125 and HE4 may provide more competent and valuable laboratory proofs for the clinical diagnosis of ovarian cancer than the detection of CA 125 alone.