甲胎蛋白联合甲胎蛋白异质体L3诊断原发性肝癌的Meta分析

目的 系统评价甲胎蛋白（AFP）联合甲胎蛋白异质体L3（AFP-L3）在原发性肝癌（HCC）中的诊断价值。方法 计算机检索国内外重要数据库，依据纳入和排除标准筛选文献，运用诊断试验准确性质量评价工具（QUADAS）评价纳入文献的质量。数据采用Meta-DiSc 1.4和Stata 12.0软件进行统计分析。结果 共纳入8篇文献，AFP联合AFP-L3检测原发性肝癌的合并敏感度（SEN）、合并特异度（SPE）、阳性似然比（+LR）、阴性似然比（-LR）、诊断优势比（DOR）分别为：0.697（0.663，0.731），0.813（0.792，0.832），4.891（3.219，7.432），0.276（0.171，0.447），20.953（10.233，42.900）。汇总受试者工作曲线（SROC）曲线下面积为0.8907，Q指数为0.8214。结论 AFP联合AFP-L3检测原发性肝癌有一定诊断价值，可作为重要的筛选指标，但仍需更多高质量、大样本、多中心的研究加以论证。

Diagnostic value of serum AFP combined with AFP-L3 in hepatocellular carcinoma: a Meta-analysis

Objective To assess the diagnostic value of AFP combined with AFP-L3 test for hepatocellular carcinoma. Methods Domestic and international databases were searched to get enough literature. The literatures were screened though the inclusion and exclusion criteria. The QUADAS was used to evaluate the quality of the included literatures. Statistical analysis of data was performed using Meta-DiSc1.4 and Stata 12.0 software. Results A total of 8 articles were included. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio of AFP combined with AFP-L3 was 0.697 (0.663, 0.731),0.813(0.792,0.832), 4.891(3.219, 7.432), 0.276 (0.171, 0.447), 20.953(10.233, 42.900), respectively. The area under the SROC curve was 0.8907, and the Q index was 0.8214.Conclusion AFP combined with AFP-L3 can be used as an important indicator in the diagnosis of primary liver cancer, but more high quality, large sample and multi-center studies were needed.