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目的:系统评价联合检测CA242、CA199和CEA在大肠癌诊断中的价值。方法:计算机检索Pub Med、EMBase、The Cochrane Library(2016年10期)、CBM、CNKI、VIP和Wang Fang Data。搜集有关联合检测CA242、CA199和CEA诊断大肠癌的临床诊断性试验,检索自建库截止至2016年10月。由2位研究人员独立进行文献筛选、数据提取和质量评价后,采用Meta-Disc1.4软件进行Meta分析。结果:共纳入12个研究,包括2 303例患者,Meta分析结果显示:(1)单独检测CA242:SEN合并=0.61[95%CI(0.58,0.64)]、SPE合并=0.87[95%CI(0.84,0.89)]、+LR合并=5.41[95%CI(3.51,8.32)]、-LR合并=0.45[95%CI(0.41,0.49)]、DOR合并=12.61[95%CI(8.05,19.76)]、SROC曲线下面积AUC=0.7500和Q指数=0.6934;(2)联合检测CA242、CA199和CEA:SEN合并=0.82[95%CI(0.80,0.84)]、SPE合并=0.88[95%CI(0.86,0.90)]、+LR合并=6.07[95%CI(4.31,8.55)]、-LR合并=0.20[95%CI(0.16,0.25)]、DOR合并=34.49[95%CI(20.59,57.79)]、SROC曲线下面积AUC=0.9167和Q指数=0.8496。结论:与C242单独检测相比,CA242、CA199和CEA联合检测诊断大肠癌具有较高的诊断效应。受纳入研究数量和质量的影响,上述结论尚需大样本高质量临床研究予以证实。
Objective: To evaluate the value of combined detection of CA242, CA199 and CEA in the diagnosis of colorectal cancer. METHODS: Pub Med, EMBase, The Cochrane Library (2016 Issue 10), CBM, CNKI, VIP and Wang Fang Data were searched by computer. To collect clinical diagnostic tests for the combined detection of CA242, CA199 and CEA in the diagnosis of colorectal cancer. Two researchers independently conducted the literature screening, data extraction and quality evaluation, Meta-Disc 1.4 software for meta-analysis. RESULTS: A total of 12 studies were enrolled, including 2,303 patients. Meta-analysis showed that: (1) CA242: SEN alone was 0.61 [95% CI (0.58,0.64)] and SPE was 0.87 [95% CI (95% CI 3.51, 8.32)], LR incorporation 0.45 [95% CI (0.41,0.49)], DOR combination = 12.61 [95% CI 8.05, 19.76 ), Area under the SROC curve AUC = 0.7500 and Q index = 0.6934; (2) combined detection of CA242, CA199 and CEA: SEN incorporation = 0.82 [95% CI (0.80, 0.84)], SPE incorporation = 0.88 [95% CI (0.86,0.90)], + LR pooled = 6.07 [95% CI (4.31,8.55)], LR pooled = 0.20 [95% CI 0.16,0.25], DOR pooled = 34.49 [95% CI 57.79)], area under the SROC curve AUC = 0.9167 and Q index = 0.8496. Conclusion: Compared with C242 alone, the combined detection of CA242, CA199 and CEA has high diagnostic value in the diagnosis of colorectal cancer. Due to the impact of the quantity and quality of the studies involved, the above conclusion still needs to be confirmed by a large sample of high-quality clinical studies.