【摘要】：目的：應(yīng)用循證醫(yī)學(xué)的方法對聯(lián)合檢測血清人附睪蛋白4(Human Epididymis Protein 4, HE4)和CA125水平在子宮內(nèi)膜癌的診斷價值進(jìn)行系統(tǒng)評價,為其診斷子宮內(nèi)膜癌提供評價依據(jù)。方法：通過計算機(jī)檢索英文數(shù)據(jù)庫,包括Cochrane圖書館、Pubmed數(shù)據(jù)庫、MEDLINE數(shù)據(jù)庫、EMBase數(shù)據(jù)庫,中文數(shù)據(jù)庫包括中國知網(wǎng)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBN)、維普中文期刊數(shù)據(jù)庫及萬方學(xué)位論文數(shù)據(jù)庫,同時手工檢索相關(guān)專業(yè)雜志,并追溯相關(guān)文獻(xiàn)的參考文獻(xiàn),文章語種不限,全面收集聯(lián)合檢測血清HE4、CA125與金標(biāo)準(zhǔn)(內(nèi)膜病理診斷)比較診斷子宮內(nèi)膜癌的相關(guān)文獻(xiàn),檢索時限均從創(chuàng)庫至2015年1月,并由兩位評價員分別單獨根據(jù)設(shè)定好的納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)對檢索文獻(xiàn)進(jìn)行篩選,對納入文獻(xiàn)進(jìn)行質(zhì)量評價、提取資料及有效數(shù)據(jù),用統(tǒng)計軟件Revman5.0中的QUADAS量表進(jìn)行質(zhì)量評價、用Meta-Disc1.4軟件對納入研究的診斷試驗結(jié)果進(jìn)行Meta分析。結(jié)果：最終納入文獻(xiàn)12篇,樣本量總共1995例,其中經(jīng)過金標(biāo)準(zhǔn)(子宮內(nèi)膜病理檢查)確診的子宮內(nèi)膜癌患者有1075例、對照組920例(其中子宮良性病變者有359例、正常婦女有561例)。Meta分析結(jié)果顯示：血清HE4+CA125檢測診斷子宮內(nèi)膜癌SEN合并=58%[95%CI(0.55,0.61)],SPE合并=92%[95%CI(0.90,0.93)],+LR合并=7.10[95%CI(3.54,14.27)],-LR合并=0.46[95%CI(0.39,0.53)],DOR合并=16.02[95%CI(7.69,33.37)],擬合SROC曲線下面積AUC=0.8696。結(jié)論：研究結(jié)果顯示,血清HE4+CA125檢測對子宮內(nèi)膜癌診斷具有較高的敏感度、特異度及AUC值,說明聯(lián)合檢測血清HE4和CA125對子宮內(nèi)膜癌的診斷有較高的臨床應(yīng)用價值。
[Abstract]:Objective: to evaluate the diagnostic value of combined detection of serum epididymal protein 4 (Human Epididymis Protein 4 (HE4) and CA125 in endometrial carcinoma by evidence-based medicine (EBM), and to provide evidence for the diagnosis of endometrial carcinoma. Methods: the English database was searched by computer, including Cochrane library, Pubmed database, MEDLINE database, EMBase database, Chinese database including China knowledge Network, Chinese Biomedical Literature Database (CBN),. Weipu Chinese periodical database and Wanfang dissertation database, at the same time manually search the relevant professional magazines, and trace back to the relevant literature references, the language of the article is not limited, comprehensive collection and joint detection of serum HE4, CA125 was compared with gold standard (pathological diagnosis of intima) in the diagnosis of intimal cancer, and the retrieval time was from the database to January 2015. the literature was compared with the gold standard (pathological diagnosis of intima). The retrieval literature was screened by the two evaluators separately according to the established inclusion standard and exclusion standard, and the quality of the included literature was evaluated, and the data and effective data were extracted. The quality of QUADAS scale in statistical software Revman5.0 was evaluated, and the diagnostic test results included in the study were analyzed by Meta software with Meta-Disc1.4 software. Results: a total of 1995 cases were included in 12 articles, of which 1075 cases were diagnosed by gold standard (endometrial pathological examination) and 920 cases in the control group (including 359 cases with benign uterine lesions). There were 561 normal women. Meta-analysis showed that serum HE4 CA125 was used to diagnose endometrial carcinoma with SEN in 58% [95%CI (0.55, 0.61)] and SPE in 92% [95%CI (0.90, 0.93)], and the results of meta-analysis showed that the diagnosis of endometrial carcinoma was 58% [95%CI (0.55, 0.61)], and 92% [95%CI (0.90, 0.93)]. LR merge = 7.10 [95%CI (3.54, 14.27)],-LR merge = 0.46 [95%CI (0.39, 0.53)], DOR merge = 16.02 [95%CI (7.69, 33.37)], fit area AUC=0.8696. under SROC curve Conclusion: the results show that the detection of serum HE4 CA125 has high sensitivity, specificity and AUC value in the diagnosis of endometrial carcinoma, which indicates that the combined detection of serum HE4 and CA125 has high clinical application value in the diagnosis of endometrial carcinoma.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R737.33

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