中国人群中血清TK1对不同恶性肿瘤诊断价值的Meta分析

目的 系统评价核酸合成的关键酶——胸苷激酶1 (TK1) 在中国人群恶性肿瘤中的诊断价值。方法 在中国期刊全文数据库(CNKI)和万方数据库中检索2008年1月至2015年3月发表的相关临床研究,采用Revman 5.2和Meta Disc 1.4进行分析。结果 共检索到相关文献415篇,最终纳入45篇,包括2 976例肿瘤患者,并全部经“金标准”确诊。Meta分析结果显示,各亚组间均存在明显的异质性,血清TK1检测在中国人群不同类型恶性肿瘤中表现出中度敏感性,其中肺癌、乳腺癌、妇科恶性肿瘤、前列腺癌、胃癌、结直肠癌、食管癌亚组的合并诊断敏感性分别为0.508、0.638、0.524、0.656、0.583、0.546、0.681;相应诊断特异性分别为0.973、0.932、0.940、0.925、0.941、0.947、0.967。结论 血清TK1检测在中国人群不同类型恶性肿瘤的筛选及早期诊断中具有一定的临床应用价值,但尚不能单独作为肿瘤筛选和辅助的诊断标准。国内评估血清TK1诊断价值的诊断性试验质量不高,存在较大的异质性,需要更多高质量的研究进一步验证。

Serum TK1 for the diagnosis of cancer in Chinese patients: a Meta-analysis

Objective To evaluate significance of thymidine kinase 1 (TK1) detection in the diagnosis of malignant tumors in Chinese patients. Methods Clinical trials on TK1 detection published during Jan. 2008 to Mar 2015 were searched in databases of CNKI and Wan Fang. Revman 5.2 and Meta Disc 1.4 were used to perform the Meta-analysis.Results A total of 415 relevant articles were retrieved and 45 trials with 2,976 cancer patients (all diagnosed by the gold standard) were involved. Meta-analyses showed that the heterogeneity among studies was high, and the pooled Results suggested a moderate diagnostic efficacy. The sensitivities for lung cancer, breast cancer, gynecological cancer, prostatic cancer, gastric cancer, intestinal cancer and esophagus cancer were 0.508, 0.638, 0.524, 0.656, 0.583, 0.546, and 0.681, respectively. The specificities were 0.973, 0.932, 0.940, 0.925, 0.941, 0.947, and 0.967. Conclusion TK1 detection may have certain value in the early diagnosis and screening of malignant cancers, but it can not be serveed as an independent reference test. More high quality trials are required to confirm the significance of TK1 detection.