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| 粪便基因甲基化对结直肠肿瘤诊断价值的Meta分析 | |
| 引用本文： | 张虎,朱尤庆,吴亚琼,郭毅,齐健.粪便基因甲基化对结直肠肿瘤诊断价值的Meta分析[J].中国循证医学杂志,2013,13(2):149-159. |
| 作者姓名： | 张虎 朱尤庆 吴亚琼 郭毅 齐健 |
| 作者单位： | 1. 武汉大学中南医院消化内科,武汉430071;湖北省肠病医学临床研究中心,湖北省肠病重点实验室,武汉430071 2. 皖南医学院附属弋矶山医院,芜湖,241001 3. 武汉大学公共卫生学院流行病学教研室,武汉,430071 |
| 基金项目： | 国家自然科学基金青年科学基金资助项目，湖北省自然科学基金资助项目 |
| 摘 要： | 目的系统评价粪便基因异常甲基化诊断结直肠肿瘤的准确性。方法计算机检索TheCochraneLibrary、PubMed、EMbase、CBM、WebofScience、CNKI和WanFangData，收集粪便基因甲基化诊断结直肠肿瘤的研究，检索时限为1990年1月至2012年2月，同时依据QUADAS条目评价纳入研究质量，采用Meta—Discl．4软件进行数据分析。结果最终共纳入32个研究，3951例患者。Meta分析结果显示：粪便基因甲基化对于检测结直肠肿瘤的合并敏感度（Sen）、特异度（Spe）、诊断比值比（DOR）、SROC曲线下面积（AUC）及Q木值分别为92％195％CI（91％，93％）]、63％95％CI（61％，65％）]、20．7995％CI（15．13，28．57）]、O．8619（SE=0．0204圾0．7926（SE=0．0198）；对于检测结直肠癌的合并Sen、Spe及SROCAUC分别为91呱95％CI（89％，92％）]、75％95％CI（73％，77％）圾0．9007；而对于结直肠腺瘤的合并Sen、Spe及SROCAUC分别为79％95％CI（76％，83％）]、759695％CI（73％，77％）]及0．8457。结论粪便基因异常甲基化对于诊断结直肠肿瘤具有较高的敏感性（92％）和中度特异性（63％），可作为诊断结直肠肿瘤的无创性初筛方法。 |
| 关 键 词： | 结直肠肿瘤 大肠癌 粪便 甲基化 系统评价 Meta分析 诊断性试验 |
Diagnostic Value of Aberrant Methylation of Genes in Stool for Colorectal Tumor: A Meta-Analysis |
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| ZHANG Hu , ZHU You-qing , WU Ya-qiong , GUO Yi , QI Jian.Diagnostic Value of Aberrant Methylation of Genes in Stool for Colorectal Tumor: A Meta-Analysis[J].Chinese Journal of Evidence-based Medicine,2013,13(2):149-159. | |
| Authors: | ZHANG Hu ZHU You-qing WU Ya-qiong GUO Yi QI Jian |
| Institution: | 1,2* 1.Department of Digestive Disease,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;2.Clinical Center of Intestinal and Colorectal Diseases of Hubei Province,Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province,Wuhan 430071,China;3.Yijishan Hospital of Wannan Medical College,Wuhu 241001,China;4.Department of Epidemiology,College of Public Health,Wuhan University,Wuhan 430071,China |
| Abstract: | Objective To evaluate the diagnostic accuracy of the aberrant methylation of genes in stool for colorec- tal tumor. Methods Databases including The Cochrane Library, PubMed, EMbase, CBM, Web of Science, CNKI and WanFang Data were searched to collect the diagnostic trials on the aberrant methylation of genes in stool for colorectal tumor published from January 1990 to February 2012. QUADAS items were used to evaluate the quality of the included studies, and the meta-analysis was conducted using Meta-Disc 1.4 software. Results A total of 32 studies involving 3 951 patients were included. The results of meta-analysis showed that, for detecting the colorectal tumor, the weighted sensitiv- ity, specificity, diagnostic odds ratio （DOR）, area under the summary receiver operating characteristic （SROC） curve and Q＊ were 92% （95%CI 91% to 93%）, 63% （95%CI 61% to 65%）, 20.79 （95%CI 15.13 to 28.57）, 0.861 9 （SE=0.020 4）, and 0.792 6 （SE=0.019 8）, respectively. For detecting the colorectal cancer, the weighted sensitivity, specificity and area under the curve （AUC） were 91% （95%CI 89% to 92%）, 75% （95%CI 73% to 77%）, and 0.900 7, respectively. For detecting the colorectal adenoma, the weighted sensitivity, specificity and AUC were 79% （95%CI 76% to 83%）, 75% （95%CI 73% to 77%）, and 0.845 7, respectively. Conclusion With high sensitivity （92%） and moderate specificity （63%）, aberrant meth- ylation of genes in stool can be used as an optional noninvasive method for the diagnosis of colorectal tumor. |
| Keywords: | Colorectal tumor Colorectal cancer Stool Methylation Systematic review Meta-analysis Diagnostic test |
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