Meta分析基质金属蛋白酶-9对恶性胸腔积液的诊断价值

摘要

Objective:To assess the value of matrix metalloproteinase-9(MMP-9)in the diagnosis of malignant pleural effusion(MPE). Method:A systematic review was conducted in Medline,Embase,Chinese Bio-medicine Database,and China Hospital Knowledge Database to identify relevant studies on evaluation of MMP-9 in the diagnosis of MPE.The methodological quality of each study was assessed by QUADAS.Statistical analysis was performed with Meta-Disc 1.4 software.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and 95%CI were calculated.Summary receiver operating characteristic(SROC)curve was made and the area under the curve(AUC)was calculated. Result:Seven studies with 613 subjects met the inclusion criteria for present analysis.The summary estimates for MMP-9 in the diagnosis of MPE were:sensitivity 75%(95%CI 0.70,0.79),specificity 75%(95%CI 0.70,0.80),positive likelihood ratio 3.53(95%CI 2.09,5.97),negative likelihood ratio 0.34(95%CI 0.28,0.41),diagnostic odds ratio 11.00(95%CI 6.09,19.84),and AUC was 0.82.Conclusion:MMP-9 plays a role in the diagnosis of MPE,while the results of MMP-9 assays should be interpreted in parallel with clinical symptoms and other test results.%　　目的：系统评价基质金属蛋白酶-9对恶性胸腔积液的诊断价值.方法：在Medline、Embase、中国生物医学文献数据库、中国生物医学期刊文献数据库等数据库进行全面检索,查找利用基质金属蛋白酶-9诊断恶性胸腔积液的文献.利用QUADAS评分工具评价纳入文献的质量.数据分析采用Meta-Disc 1.4软件,计算合并敏感度、特异度、阳性似然比、阴性似然比、诊断优势比及其95%CI.绘制汇总受试者工作特征曲线,对基质金属蛋白酶-9的诊断准确性进行综合评估.结果：共有7篇文献613例研究对象纳入本次Meta分析,分析结果显示基质金属蛋白酶-9对恶性胸腔积液的合并诊断价值分别为：敏感度为75%[95%CI(0.70,0.79)],特异度为75%[95%CI(0.70,0.80)],阳性似然比为3.53[95%CI(2.09,5.97)],阴性似然比为0.34[95%CI(0.28,0.41)],诊断比值比为11.00[95%CI(6.09,19.84)].汇总受试者工作特征曲线下面积为0.82.结论：基质金属蛋白酶-9在恶性胸腔积液的诊断中具有一定的临床价值,其检测结果的解读需要综合考虑患者的临床症状和其他检测指标.