国内13种血清肿瘤标志物对肺癌诊断价值的Meta分析

目的 探讨国内13种单一和联合的血清肿瘤标志物对肺癌的诊断价值。方法 全面、系统检索国内数据库中血清肿瘤标志物对肺癌诊断价值的研究并进行Meta分析。结果 纳入文献30篇,共4 393人,涉及血清肿瘤标志物13种。最优的联合诊断标志物为CEA+CA125+CYFRA21-1,其联合检测的灵敏度、特异度、阳性似然比、阴性似然比、诊断优势比和SROC曲线下面积(AUC)分别为87%95%置信区间(CI)0.81～0.91],93%(95%CI 0.89～0.95),11.8(95%CI 7.84～17.7),0.15(95%CI 0.10～0.21),81.3(95%CI 44.4～149.0)和0.910。结论 联合标志物的诊断效能优于单一指标,标志物CEA+CA125+CYFRA21-1是较为理想的诊断肺癌的肿瘤标志物。

Diagnostic Value of Thirteen Types of Serum Tumor Markers for Lung Cancer in China:A Meta-Analysis

Objective To evaluate diagnostic values of thirteen single and combined serum tumor markers in the diagnosis of lung cancer inChinese people.Methods Chinese databases were searched systematically for prospective studies of serum tumor markers in Chinese patientswith lung cancer and standard statistical methods for meta-analysis were applied.Results Thirty articles were selected containing thirteen types of molecular tumor markers and 4 393 people.The optimal serum marker was CEA+CA125+CYFRA21-1 with the combined sensitivity,specificity,positivelikelihood ratio,negative likelihood ratio,the diagnostic odds ratio and the area under the summary receiver operating characteristic curve(AUC)was 87%95%confidence interval(CI)0.81～0.91],93%(95% CI 0.89～0.95),11.8(95% CI 7.84～17.7),0.15(95% CI 0.10～0.21),81.3(95% CI 44.4～149.0)and 0.910,respectively.Conclusion There was improved diagnostic performance in combined markers than other individuals.Serum tumor marker CEA+CA125+CYFRA21-1 is the optimal biomarker for the diagnosis of lung cancer.