【摘要】：背景與目的:Survivin基因逐漸成為腫瘤診斷、判斷預(yù)后和治療的靶點(diǎn)。用RT-PCR技術(shù)檢測(cè)尿液中survivin mRNA作為一種無(wú)創(chuàng)性手段用于膀胱癌的診斷,國(guó)內(nèi)外相關(guān)研究較多,但其結(jié)果不一。本研究旨在應(yīng)用系統(tǒng)評(píng)價(jià)方法對(duì)相關(guān)文獻(xiàn)進(jìn)行客觀評(píng)價(jià),以評(píng)估RT-PCR技術(shù)檢測(cè)尿液中survivin mRNA對(duì)膀胱癌的診斷價(jià)值。方法:以膀胱腫瘤、生存素、逆轉(zhuǎn)錄-聚合酶鏈反應(yīng)、敏感度、特異度、診斷等為主要檢索詞檢索PubMed、EMBASE、SCI、Cochrane Library、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBM)、相關(guān)期刊論文(CJFD)、中文科技期刊數(shù)據(jù)庫(kù)(CSJD)、中華醫(yī)學(xué)會(huì)數(shù)字化期刊等數(shù)據(jù)庫(kù),并結(jié)合Google Scholar等搜索引擎全面搜集1997年到2009年4月關(guān)于RT-PCR檢測(cè)尿液survivin mRNA診斷膀胱癌的研究。根據(jù)QUADAS(quality assessment of diagnostic accuracy studies)質(zhì)量評(píng)價(jià)標(biāo)準(zhǔn)評(píng)價(jià)納入文獻(xiàn)質(zhì)量,用Meta-Disc軟件對(duì)結(jié)果指標(biāo)進(jìn)行分析。結(jié)果:最終納入26個(gè)研究,共2416例。Meta分析結(jié)果顯示,RT-PCR技術(shù)檢測(cè)尿液中survivin mRNA診斷膀胱癌與病理檢查相比準(zhǔn)確度指標(biāo)合并敏感度、特異度、陽(yáng)性似然比、陰性似然比及SROC曲線下面積分別為88%、94%、14.56、0.13、0.9736;巢式RT-PCR技術(shù)檢測(cè)的敏感度、特異度及SROC曲線下面積最高,分別為91%、95%、0.9805;普通RT-PCR技術(shù)檢測(cè)的敏感度和特異度次之,分別為87%和94%;定量RT-PCR技術(shù)檢測(cè)的敏感度為80%,特異度為93%。結(jié)論:與病理檢查相比,RT-PCR技術(shù)檢測(cè)尿液中survivin mRNA診斷膀胱癌有較高的敏感度和特異度,可作為膀胱鏡檢查的主要輔助手段之一,用于膀胱癌的篩查及術(shù)后監(jiān)測(cè)。
[Abstract]:Background & objective: Survivin gene has gradually become a target for tumor diagnosis, prognosis and treatment. The detection of survivin mRNA in urine by RT-PCR is a non-invasive method for the diagnosis of bladder cancer. There are many related studies at home and abroad, but the results are not the same. The aim of this study was to evaluate the diagnostic value of RT-PCR in the detection of urinary survivin mRNA in bladder cancer by systematically evaluating the related literatures. Methods: using bladder tumor, survivin, reverse transcription-polymerase chain reaction (RT-PCR), sensitivity, specificity and diagnosis as the main search words, we searched PubMed,EMBASE,SCI,Cochrane Library, Chinese Biomedical Literature Database (CBM),). Chinese journal full-text database (CJFD), Chinese sci-tech journal database (CSJD), Chinese medical association digital journals and other databases, Combined with Google Scholar and other search engines, a comprehensive collection of RT-PCR detection of urine survivin mRNA diagnosis of bladder cancer research from 1997 to April 2009. According to the QUADAS (quality assessment of diagnostic accuracy studies) quality evaluation criteria, the results were analyzed by Meta-Disc software. Results: a total of 2416 cases were included in 26 studies. The results of meta-analysis showed that the accuracy index, sensitivity, specificity and positive likelihood ratio of RT-PCR technique in the diagnosis of bladder cancer were higher than that of pathological examination, and the sensitivity, specificity and positive likelihood ratio were higher than those of pathological examination. The negative likelihood ratio and the area under SROC curve were 88%, 94%, 14.56, 0.13,0.9736, respectively. The sensitivity, specificity and area under SROC curve of nested RT-PCR were the highest, which were 91%, 95%, 0.9805, respectively, and the sensitivity and specificity of common RT-PCR were 87% and 94%, respectively. The sensitivity and specificity of quantitative RT-PCR were 80% and 93% respectively. Conclusion: compared with pathological examination, RT-PCR technique has higher sensitivity and specificity in the diagnosis of bladder cancer. It can be used as one of the main auxiliary methods of cystoscopy to screen bladder cancer and monitor it after operation.
【作者單位】： 蘭州大學(xué)循證醫(yī)學(xué)中心;蘭州大學(xué)基礎(chǔ)醫(yī)學(xué)院生物化學(xué)與分子生物學(xué)研究所;
【分類號(hào)】：R737.14

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本文編號(hào)：2433778