中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2010年
3期
185-189
,共5页
杨明根%赵晓昆%吴志平%侯轶
楊明根%趙曉昆%吳誌平%侯軼
양명근%조효곤%오지평%후질
膀胱肿瘤%膀胱肿瘤抗原%Meta 分析
膀胱腫瘤%膀胱腫瘤抗原%Meta 分析
방광종류%방광종류항원%Meta 분석
Urinary bladder neoplasms%BTA stat%Meta-analysis
目的 系统评价尿液中膀胱肿瘤抗原(BTA stat)检测诊断膀胱肿瘤的临床价值.方法制定原始文献的纳入标准、排除标准及检索策略,在MEDLINE(1966年1月-2008年6月)、EMBASE(1988年1月-2008年6月)、Cochrane图书馆、中国生物医学期刊文献数据库(1979年1月-2008年6月)、CNKl数字图书馆(1979年1月-2008年6月)进行有关尿BTA stat诊断膀胱癌文献的检索、质量评价和资料提取.采用MetaDiScl.4软件进行Meta分析. 结果 共检索到相关研究71篇,排除51篇,符合纳入标准20篇进入Meta分析,涉及研究对象5929例.异质性检验提示存在异质性.按随机效应模型进行Meta分析,BTA stat诊断膀胱癌的准确度指标敏感性、特异性、阳性似然比、阴性似然比以及诊断优势比等汇总值分别为0.64(95%CI 0.62～0.66)、0.72(95%CI 0.70～0.73)、2.33(95%CI 2.03～2.68)、0.48(95%CI 0.42～0.55)及5.12(95%CI 3.88～6.75).其敏感性随肿瘤病理分级和分期的升高而增加,且初发肿瘤的敏感性高于复发肿瘤.综合受试者工作特征曲线下面积为0.7500,Q*=0.6934. 结论 尿BTA stat检测诊断膀胱肿瘤的准确度中等,可以作为膀胱镜检查的重要辅助手段.
目的 繫統評價尿液中膀胱腫瘤抗原(BTA stat)檢測診斷膀胱腫瘤的臨床價值.方法製定原始文獻的納入標準、排除標準及檢索策略,在MEDLINE(1966年1月-2008年6月)、EMBASE(1988年1月-2008年6月)、Cochrane圖書館、中國生物醫學期刊文獻數據庫(1979年1月-2008年6月)、CNKl數字圖書館(1979年1月-2008年6月)進行有關尿BTA stat診斷膀胱癌文獻的檢索、質量評價和資料提取.採用MetaDiScl.4軟件進行Meta分析. 結果 共檢索到相關研究71篇,排除51篇,符閤納入標準20篇進入Meta分析,涉及研究對象5929例.異質性檢驗提示存在異質性.按隨機效應模型進行Meta分析,BTA stat診斷膀胱癌的準確度指標敏感性、特異性、暘性似然比、陰性似然比以及診斷優勢比等彙總值分彆為0.64(95%CI 0.62～0.66)、0.72(95%CI 0.70～0.73)、2.33(95%CI 2.03～2.68)、0.48(95%CI 0.42～0.55)及5.12(95%CI 3.88～6.75).其敏感性隨腫瘤病理分級和分期的升高而增加,且初髮腫瘤的敏感性高于複髮腫瘤.綜閤受試者工作特徵麯線下麵積為0.7500,Q*=0.6934. 結論 尿BTA stat檢測診斷膀胱腫瘤的準確度中等,可以作為膀胱鏡檢查的重要輔助手段.
목적 계통평개뇨액중방광종류항원(BTA stat)검측진단방광종류적림상개치.방법제정원시문헌적납입표준、배제표준급검색책략,재MEDLINE(1966년1월-2008년6월)、EMBASE(1988년1월-2008년6월)、Cochrane도서관、중국생물의학기간문헌수거고(1979년1월-2008년6월)、CNKl수자도서관(1979년1월-2008년6월)진행유관뇨BTA stat진단방광암문헌적검색、질량평개화자료제취.채용MetaDiScl.4연건진행Meta분석. 결과 공검색도상관연구71편,배제51편,부합납입표준20편진입Meta분석,섭급연구대상5929례.이질성검험제시존재이질성.안수궤효응모형진행Meta분석,BTA stat진단방광암적준학도지표민감성、특이성、양성사연비、음성사연비이급진단우세비등회총치분별위0.64(95%CI 0.62～0.66)、0.72(95%CI 0.70～0.73)、2.33(95%CI 2.03～2.68)、0.48(95%CI 0.42～0.55)급5.12(95%CI 3.88～6.75).기민감성수종류병리분급화분기적승고이증가,차초발종류적민감성고우복발종류.종합수시자공작특정곡선하면적위0.7500,Q*=0.6934. 결론 뇨BTA stat검측진단방광종류적준학도중등,가이작위방광경검사적중요보조수단.
Objective To systematic review bladder tumor antigen(BTA) stat in the diagnosis of bladder cancer. Methods MEDLINE, EMBASE, Cochrane Library, CMCC and CNKI were searched for studies about BTA stat in the diagnosis of bladder cancer. The search strategy was made according to the Collaborative Review Group search strategy. Data were extracted by two reviewers using the designed extraction form. The software MetaDiScl. 4 was used to review management and data analysis. Results Seventy-one relevant studies were searched, of which 20 studies were included with 5929 patients involved and 51 studies were excluded. Heterogeneity (except for threshold effect) was found within these studies. A meta-analysis was performed using random effect model. Pooled accuracy indicators like sensitivity, specificity, positive likelihood ratio (LR), negative LR and diagnostic odds ratio (dOR) were 0. 64(95%CI 0. 62-0. 66), 0. 72(95%CI 0. 70-0. 73) , 2. 33(95% CI 2. 03-2. 68), 0. 48(95%CI 0.42 -0.55) and 5.12(95%CI 3. 88-6. 75), respectively. The sensitivity increased with tumor grades. The sensitivity of primary tumors was higher than the recurrent tumors. Area under curve (AUC) of SROC curve was 0. 7500 and Q* index was 0. 6934. Conclusions The performance of urine BTA stat is moderate in the diagnosis of bladder tumor. It can be an optional non-invasive test and an important adjunct test in preoperative detecting and postoperative monitoring of bladder tumor.
