胰腺癌肿瘤标志物临床价值系统评估

目的 运用meta分析比较CA19-9和CA242诊断胰腺癌的敏感性和特异性.方法 检索PubMed、Embase、Cochrane数据库（1996年至2011年）,用meta分析符合纳入标准的11项研究,2316例患者,计算CA242和CA19-9的平均敏感性、特异性.结果 CA242和CA19-9的平均敏感性分别为71.9％（95％ CI：69.0％～74.6％）、80.3％ （95％ CI：77.7％～82.6％）;CA242和CA19-9的平均特异性分别为86.8％ （95％ CI：84.9％ ～ 85.5％）、80.2％ （95％ CI：78.0％ ～ 80.3％）.CA242的诊断比值比为16.261,明显高于CA19-9（15.637）.结论 CA242和CA19-9对诊断胰腺癌有重要的临床价值,虽然CA242的敏感性低于CA19-9,但是CA242的特异性高于CA19-9.

The Systemic Assessment to the Clinical Value of Serum Tumor Markers for the Diagnosis of Pancreatic Cancer

Objective Pancreatic cancer has the worst prognosis of any gastrointestinal cancer,with the mortality approaching the incidence.Early detection is crucial for improving patient prognosis.We therefore performed a meta-analysis to evaluate and compare the sensitivity and specificity of CA19-9 and CA242 in pancreatic cancer.Methods We searched PubMed,EMBASE and the Cochrane Library for studies that evaluated the diagnostic validity of CA19-9 and CA242 between January 1966 and March 2011.Meta-analysis methods were used to pool sensitivity and specificity and to construct a summary receiver-operating characteristic （SROC）curve.Results A total of 11 studies that included 2316 patients who full filled all of the inclusion criteria were considered for analysis.The pooled sensitivities for CA242 and CA19-9 were 0.719 （95％ CI：0.690-0.746） and 0.803 （95％ CI：0.777-0.826）,respectively.The pooled specificities of CA242 and CA19-9were 0.868 （95％ CI：0.849-0.885） and 0.802 （95％ CI,0.780-0.823）,respectively.The diagnostic odds ratio （DOR） estimate was significantly higher for CA242 （16.261） than for CA19-9 （15.637）.Conclusion Our meta-analysis showed that CA242 and CA19-9 could play different roles in the diagnosis of pancreatic cancer.Although the sensitivity of CA242 is lower than that of CA19-9,its specificity is greater.