【摘要】：目的：目前CAl25、HE4和ROMA可用于診斷卵巢癌，國內(nèi)外許多研究報道了它們對卵巢癌診斷價值的比較。然而，，其中這些診斷方法哪個能產(chǎn)生最佳的診斷準(zhǔn)確性并沒有被最終確定。因此，本文進行Meta分析以評估這些診斷方法的診斷價值。 方法：系統(tǒng)全面地檢索萬方、VIP、CNKI、CBM等中文數(shù)據(jù)庫及Pubmed、Medline、The Cochrane Library等英文數(shù)據(jù)庫，共收集了15項關(guān)于評估CA125、HE4和Roma對卵巢癌診斷價值的研究，采用Meta—Discl.4軟件首先進行閾值效應(yīng)分析，再根據(jù)絕經(jīng)狀態(tài)、FIGO分期、病理類型、檢測方法和試驗設(shè)計（盲法試驗與無/未報告）對其異質(zhì)性進行分層亞組分析，采用Stata12.0軟件進行敏感性分析并選用Deek’S漏斗圖進行發(fā)表偏倚檢測，采用Z檢驗對HE4、CA125和Roma檢測對卵巢癌的診斷性能進行比較，P0．05為差異有統(tǒng)計學(xué)意義。 結(jié)果：三種測試方法對于卵巢癌的診斷具有相似的診斷準(zhǔn)確度（AUC[95％CI]：HE4為0.88[0.85-0.91];CA125為0.86[0.83-0.89];Roma為0.90[0.87-0.92]），但與CA125和ROMA相比HE4具有更高的特異性（HE493.60[90.00-95.90]CA12582.10[76.60-86.50]和ROMA82.40[77.40-86.50]），尤其是在絕經(jīng)前亞組（HE493.80[88.40-96.80]CA12576.30[63.30-85.70]和ROMA85.10[80.40-88.80]）；與此相反，CA125和Roma在絕經(jīng)后亞組比在絕經(jīng)前亞組有更優(yōu)的診斷準(zhǔn)確性(AUC[95％CI]：CA125絕經(jīng)前0.84[0.81-0.87]絕經(jīng)后0.91[0.88-0.93];ROMA絕經(jīng)前0.85[0.82-0.88]絕經(jīng)后0.92[0.89-0.94]）。 結(jié)論：HE4由于其高特異性，其將可能成為診斷OCA有用的腫瘤標(biāo)志物，尤其是對于絕經(jīng)前女性；CA125和Roma更適合于絕經(jīng)后女性診斷OCA。這一結(jié)論仍需要更多高質(zhì)量的隨機對照試驗對其進行驗證。
[Abstract]:Objective: Cal 25 he 4 and ROMA can be used in the diagnosis of ovarian cancer. However, which of these diagnostic methods can produce the best diagnostic accuracy has not been finalized. Therefore, Meta analysis is performed to evaluate the diagnostic value of these diagnostic methods. Methods: a total of 15 Chinese databases, such as CNKICBM and Pubmedan Medline Cochrane Library, were searched systematically. Fifteen studies were conducted to evaluate the diagnostic value of CA125HE4 and Roma for ovarian cancer. The threshold effect was analyzed by Meta-Discl.4 software. The heterogeneity was analyzed by stratified subgroup analysis according to the stage of menopausal stage, pathological type, detection method and test design (blind test and no / no report). Sensitivity analysis was carried out by Stata12.0 software and Deek'S funnel graph was used to detect publication bias. Z test was used to compare the diagnostic performance of HE4CA125 and Roma in ovarian cancer. There was significant difference between them (P0.05). 緇撴灉錛氫笁縐嶆祴璇曟柟娉曞浜庡嵉宸㈢檶鐨勮瘖鏂叿鏈夌浉浼肩殑璇婃柇鍑嗙‘搴

本文編號：2141087