骨桥蛋白对恶性胸膜间皮瘤诊断价值的Meta分析

目的 探讨骨桥蛋白(osteopontin,OPN)检测对恶性胸膜间皮瘤(malignant pleural mesothelioma,MPM)的诊断价值。方法 在Medline 、Embase及Cochrane图书馆数据库中,使用合适的关键词,检索截至2015年9月5日发表的有关评价OPN对恶性胸膜间皮瘤诊断价值的英文文献,由两名评价者使用QUADAS-2工具独立评价文献质量。采用随机效应模型进行统计分析得到OPN诊断MPM的总的敏感度、特异性及诊断比值比;应用SROC (summary receiver operating characteristic curves) 评估OPN诊断MPM的总体性能。结果 共纳入7篇研究文献。汇总后的结果为:敏感度为0.59(95％ CI:0.54~0.63),特异性为0.85(95％ CI:0.83~0.87),诊断比值比为10.63(95％ CI:7.73~14.60)。SROC曲线下面积为0.839,Q值为0.771。结论 OPN可能是诊断MPM的一种有效标志物,鉴于已有的研究数量和病例数较少,尚需更多研究来验证OPN对MPM的诊断价值。

Meta Analysis of the Diagnostic Accuracy of Osteopontin for Malignant Pleural Mesothelioma

Objective To investigate the diagnostic value of osteopontin for malignant pleural mesothelioma (MPM). Methods Using appropriate keywords, qualified studies published in English till September 05, 2015 on evaluation of circulating levels of osteopontin for the diagnosis of MPM were retrieved from Medline, Embase and The Cochrane Library datebases. The tool of QUADAS-2 was used by two reviewers to assess the quality of the studies. The total sensitivity, specificity and diagnostic odds ratio of OPN in the diagnosis of MPM were obtained by using the random effect model. The total diagnostic performance of OPN was evaluated by summary receiver operating characteristic curves (SROC) approaches. Results A total of 7 studies were included in the analysis. The summary estimates as follows: Sensitivity was 0.59 (95% confidence interval: 0.54-0.63), specificity was 0.85 (95% confidence interval: 0.83-0.87), diagnostic odds ratio was 10.63 (95% confidence interval: 7.73-14.60). The area under curve (AUC) was 0.839 with Q value of 0.771. Conclusion OPN may be an effective marker for the diagnosis of MPM. In view of the limited studies and patients included, more research is required to verify these findings.