肝素酶与恶性肿瘤淋巴结转移的相关性评价

目的采用Meta分析方法系统评价肝素酶与恶性肿瘤淋巴结转移的关系。方法通过电子检索与手工检索等途径全面收集有关肝素酶与恶性肿瘤淋巴结转移关系的符合纳入标准的文献,限于中文和英文,截止日期为2009年10月。在纳入的研究中包括:以研究肝素酶与恶性肿瘤淋巴结转移的关系;术前未进行化疗和放疗,均有病理诊断作为金标准对照;提供的数据完整,能得到四格表资料。所有数据使用RevMan Manager 4.2软件进行Meta分析。结果关于肝素酶与恶性肿瘤淋巴结转移关系的文献共检出156篇,其中符合纳入标准的共38篇,英文3篇,中文35篇。38项研究经Meta分析显示,肝素酶检测对判断恶性肿瘤淋巴结转移的合并灵敏度为76.0%,合并特异度为58.8%;合并阳性预测值为67.3%;合并阴性预测值为68.7%;合并阳性似然比为+LR=1.84;合并阴性似然比为-LR=0.54;合并比值比(OR)为6.26,95%可信区间5.18～7.57。结论肝素酶对判断恶性肿瘤淋巴结转移的敏感度较高,且有较高的阴性预测值,肝素酶的表达与恶性肿瘤淋巴结转移呈正相关。

Systematic evaluation to relationship between heparanase and carcinoma lymph node metastasis

Objective To evaluate the relationship between heparanase and the cancer lymph node metastasis by means of a systematic evaluation. Methods By ways of electronic and manual searches,we collected comprehensively English and Chinese literatures about the relationship between heparanase and the cancer lymph node metastasis,which were published before October in 2009. The researches included the relationship between heparanase and the cancer lymph node metastasis,without preoperative chemotherapy and adiotherapy. All had the pathological diagnosis as gold standard, provided the data indegrity and got fourfold table information. All data were performed Meta analysis with the software RevMan Manager 4.2. Results The number of the literature about the relationship between heparanase and the cancer metastasis was 156 in all. Among them,there were 38 papers conforming to the ineluding criteria,3 in English and 35 in Chinese. The Fourfold table data in 38 researches were performed Meta analysis by using the software RevMan Manager 4. 2. The results showed that the pooled sensitivity（SEN） ：76.0%;the pooled specificity （SPN） ： 58.8 % ; the positive predictive value （ ＋ PV） ： 67.3 % ; the negative predictive value （PV） ： 68.7% ;the positive likelihood ratio （-LR）.. 1. 84; the negative likelihood ratio （-LR） ： 0. 54; the pooled odd ratio （OR）：6.26; the 95% confidence intervals （CI）： （5. 18,7. 57）. Conclusion Heparanase is sensitive to determine lymph node metastasis of malignant tumors,and there is also a high negative predictive figure. Expression in lymph node metastasis and malignant tumors shows the positive interrelation.