血清高尔基体蛋白 73 对乙型肝炎病毒相关性肝癌诊断价值 的 Meta 分析
| 作者: |
1肖扬,
1陈能志
1 南华大学附属常德医院 普通外科，湖南 常德 415000 |
| 通讯: |
陈能志
Email: CNZ01@126.com |
| DOI: | 10.3978/.2018.07.008 |
| 基金: | 湖南省常德市科技局技术研究与开发资金资助项目（2016KZ01）。 |
摘要
目的：探讨血清高尔基体蛋白 73（GP73）对乙型肝炎病毒（HBV）相关性肝癌的诊断价值。
方法：计算机系统性检索国内外公开发表的相关文献。采用 Meta-Disc1.4 软件汇总诊断准确性指标，计算综合受试者工作特征曲线（SROC）、曲线下面积（AUC）和 Q* 指数。采用 Stata 14.0 软件计算验后概率，并绘制 Fagan 图来评估 GP73 的临床应用价值。
结果：最终纳入 14 篇文献，总样本量为 3 953 例。血清 GP73 诊断 HBV 相关性肝癌的总敏感度为0.70（95% CI=0.68~0.73）， 总 特 异 度 为 0.75（95% CI=0.73~0.77）， 总 阳 性 似 然 比 为 3.37（95% CI= 2.75~4.13）， 总阴性似然比为 0.36（95% CI=0.29~0.45）， 诊断比值比（DOR）为 9.67（95% CI= 6.72~13.91），AUC 和 Q* 指数分别为 0.826 和 0.759。当设定验前概率为 50% 时，阳性、阴性 GP73的验后概率分别为 78% 和 26%。
结论：血清 GP73 对 HBV 相关性肝癌有一定的诊断意义，但其单独应用于确诊或排除该病的价值有限，尚需结合其他检查。
关键词：
癌，肝细胞；乙型肝炎病；生物标记，肿瘤；Meta 分析
方法：计算机系统性检索国内外公开发表的相关文献。采用 Meta-Disc1.4 软件汇总诊断准确性指标，计算综合受试者工作特征曲线（SROC）、曲线下面积（AUC）和 Q* 指数。采用 Stata 14.0 软件计算验后概率，并绘制 Fagan 图来评估 GP73 的临床应用价值。
结果：最终纳入 14 篇文献，总样本量为 3 953 例。血清 GP73 诊断 HBV 相关性肝癌的总敏感度为0.70（95% CI=0.68~0.73）， 总 特 异 度 为 0.75（95% CI=0.73~0.77）， 总 阳 性 似 然 比 为 3.37（95% CI= 2.75~4.13）， 总阴性似然比为 0.36（95% CI=0.29~0.45）， 诊断比值比（DOR）为 9.67（95% CI= 6.72~13.91），AUC 和 Q* 指数分别为 0.826 和 0.759。当设定验前概率为 50% 时，阳性、阴性 GP73的验后概率分别为 78% 和 26%。
结论：血清 GP73 对 HBV 相关性肝癌有一定的诊断意义，但其单独应用于确诊或排除该病的价值有限，尚需结合其他检查。
Diagnostic value of serum Golgi protein 73 for HBV-related hepatocellular carcinoma: a Meta-analysis
CorrespondingAuthor:Nengzhi CHEN Email: CNZ01@126.com
Abstract
Objective: To evaluate the diagnostic value of serum Golgi protein 73 (GP73) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).
Methods: A computer-based systematic search of publically published literature of relevant studies in China and abroad was performed. Th e indexes for diagnostic accuracy were pooled, and the area under carve (AUC) of the summary receiver operating characteristic carve (SROC) and Q* index were calculated by using Meta-Disc1.4 soft ware. Th e post-test probability was calculated, and Fagan’s nomograms were drawn to assess the application value of GP73 by using Stata 14.0 soft ware.
Results: A total of 14 studies were finally included, with a total sample size of 3 953 subjects. The pooled sensitivity and specificity of GP73 in diagnosis of HBV-related HCC were 0.70 (95% CI=0.68 0.73) and 0.75 (95% CI=0.73–0.77) respectively, and the pooled positive likelihood ratio and negative likelihood ratio were 3.37 (95% CI=2.75–4.13) and 0.36 (95% CI=0.29 0.45), respectively. The summary diagnostic odds ratio (DOR) was 9.67 (95% CI=6.72–13.91), and the AUC and Q* index were 0.826 and 0.759, respectively. For a pre-test probability of 50%, the post-test probabilities for positive and negative test of GP73 were 78% and 26%, respectively. Conclusion: GP73 has certain value in diagnosis of HBV-related HCC, but the value of its lone use for confirmation or exclusion of this disease is limited and other combined examinations are required.
Keywords：
Carcinoma
Hepatocellular; Hepatitis B virus; Biomarkers
Tumor; Meta-Analysis
Methods: A computer-based systematic search of publically published literature of relevant studies in China and abroad was performed. Th e indexes for diagnostic accuracy were pooled, and the area under carve (AUC) of the summary receiver operating characteristic carve (SROC) and Q* index were calculated by using Meta-Disc1.4 soft ware. Th e post-test probability was calculated, and Fagan’s nomograms were drawn to assess the application value of GP73 by using Stata 14.0 soft ware.
Results: A total of 14 studies were finally included, with a total sample size of 3 953 subjects. The pooled sensitivity and specificity of GP73 in diagnosis of HBV-related HCC were 0.70 (95% CI=0.68 0.73) and 0.75 (95% CI=0.73–0.77) respectively, and the pooled positive likelihood ratio and negative likelihood ratio were 3.37 (95% CI=2.75–4.13) and 0.36 (95% CI=0.29 0.45), respectively. The summary diagnostic odds ratio (DOR) was 9.67 (95% CI=6.72–13.91), and the AUC and Q* index were 0.826 and 0.759, respectively. For a pre-test probability of 50%, the post-test probabilities for positive and negative test of GP73 were 78% and 26%, respectively. Conclusion: GP73 has certain value in diagnosis of HBV-related HCC, but the value of its lone use for confirmation or exclusion of this disease is limited and other combined examinations are required.