【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。用RT-PCR技術(shù)檢測尿液中survivin mRNA作為一種無創(chuàng)性手段用于膀胱癌的診斷,國內(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)評價方法對相關(guān)文獻(xiàn)進(jìn)行客觀評價,以評估RT-PCR技術(shù)檢測尿液中survivin mRNA對膀胱癌的診斷價值。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、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、相關(guān)期刊論文(CJFD)、中文科技期刊數(shù)據(jù)庫(CSJD)、中華醫(yī)學(xué)會數(shù)字化期刊等數(shù)據(jù)庫,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)量評價標(biāo)準(zhǔn)評價納入文獻(xiàn)質(zhì)量,用Meta-Disc軟件對結(jié)果指標(biāo)進(jìn)行分析。結(jié)果:最終納入26個研究,共2416例。Meta分析結(jié)果顯示,RT-PCR技術(shù)檢測尿液中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。
[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】：R737.14

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 汪良,曾甫清,廖貴益,陳方敏;檢測膀胱癌患者尿液脫落細(xì)胞中Survivin的表達(dá)及意義[J];臨床泌尿外科雜志;2004年08期

2 王海平;陳照彥;孫世平;周力;趙柏;;膀胱移行細(xì)胞癌中Survivin基因的檢測及臨床意義[J];臨床泌尿外科雜志;2005年12期

3 陳冠峰;龐自力;許景東;;膀胱移行細(xì)胞癌患者尿脫落細(xì)胞中生存素的檢測及其意義[J];臨床泌尿外科雜志;2006年01期

4 袁龍;王劍松;盧永偉;左毅剛;石永福;楊德林;徐鴻毅;;尿及癌組織中Survivin的表達(dá)對膀胱癌的早期診斷價值[J];現(xiàn)代泌尿外科雜志;2006年04期

5 萬江華;靳風(fēng)爍;向德兵;胡波;高飛;;細(xì)胞角質(zhì)素20和存活素在膀胱癌診斷中的價值[J];醫(yī)學(xué)臨床研究;2008年03期

6 盧志賢;曹利民;程華莉;陳江;;尿脫落細(xì)胞中生存素基因表達(dá)與膀胱腫瘤的關(guān)系[J];中國臨床醫(yī)學(xué);2007年02期

7 姜果;張建華;姜榮建;陳仲達(dá);;Survivin mRNA水平及透明質(zhì)酸含量測定在膀胱移行細(xì)胞癌診斷及預(yù)后判斷中的臨床意義[J];四川醫(yī)學(xué);2006年11期

8 李艷;;尿Cox-2蛋白、Survivin mRNA和脫落細(xì)胞學(xué)檢查對膀胱移行細(xì)胞癌的診斷價值[J];山東醫(yī)藥;2008年19期

9 汪官富;羅利飛;韓子華;;尿survivin mRNA診斷膀胱移行細(xì)胞癌的臨床價值[J];實用醫(yī)學(xué)雜志;2007年09期

10 黃力;陳立新;張孝斌;姚啟盛;王曉康;;膀胱移行細(xì)胞癌尿液脫落細(xì)胞中survivin的表達(dá)及意義[J];實用醫(yī)學(xué)雜志;2007年24期

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 楊慎敏;溫端改;侯建全;何軍;岑建農(nóng);陳劍華;;原位膀胱癌動物模型的建立及應(yīng)用[J];癌癥;2007年04期

2 王小林;侯建全;溫端改;何軍;;Survivin小分子干擾RNA對膀胱癌T24細(xì)胞生物學(xué)行為的影響[J];癌癥;2008年03期

3 蒲小勇;王志平;陳一戎;吳一龍;王懷鵬;王行環(huán);;聯(lián)合檢測UBC、HA和CK20診斷膀胱癌的臨床價值[J];癌癥;2008年09期

4 李靜然;魏麗惠;劉寧;趙麗君;韋平;趙超;崔淑慧;屠，

本文編號：2433778