CAJ | 학술논문

目的探讨血清标志物磷脂酰肌醇蛋白聚糖-3(GPC3)联合甲胎蛋白(AFP)检测对比单项检测AFP对原发性肝癌的诊断价值.方法检索已发表的有关联合检测血清GPC3和AFP及单项检测AFP诊断原发性肝癌的文献.按纳入与排除标准筛选文献、提取数据.采用STATA 12.0软件对诊断准确度指标进行Meta分析.分别绘制综合受试者工作特征曲线比较两者差异.结果经过筛选最终19篇文献人选.异质性检验提示GPC3和AFP联合检测不存在阈值效应,但存在由其他因素引起的异质性,故选择随机效应模型进行Meta分析.分析显示:AFP单项检测诊断原发性肝癌的汇总灵敏度、特异性分别为0.61、0.93;GPC3联合AFP检测的汇总灵敏度、特异性分别为0.84、0.86.AFP的综合受试者工作特征曲线下面积和Q指数分别为0.81和0.75;GPC3联合AFP检测的综合受试者工作特征曲线下面积和Q指数分别为0.91和0.85.结论 GPC3联合AFP检测能显著提高肝癌诊断的灵敏度,并且特异性仍保持在较高水平(0.86),有助于肝癌的早期诊断与筛查.
목적 탐토혈청표지물린지선기순단백취당-3(GPC3)연합갑태단백(AFP)검측대비단항검측AFP대원발성간암적진단개치.방법 검색이발표적유관연합검측혈청GPC3화AFP급단항검측AFP진단원발성간암적문헌.안납입여배제표준사선문헌、제취수거.채용STATA 12.0연건대진단준학도지표진행Meta분석.분별회제종합수시자공작특정곡선비교량자차이.결과 경과사선최종19편문헌인선.이질성검험제시GPC3화AFP연합검측불존재역치효응,단존재유기타인소인기적이질성,고선택수궤효응모형진행Meta분석.분석현시:AFP단항검측진단원발성간암적회총령민도、특이성분별위0.61、0.93;GPC3연합AFP검측적회총령민도、특이성분별위0.84、0.86.AFP적종합수시자공작특정곡선하면적화Q지수분별위0.81화0.75;GPC3연합AFP검측적종합수시자공작특정곡선하면적화Q지수분별위0.91화0.85.결론 GPC3연합AFP검측능현저제고간암진단적령민도,병차특이성잉보지재교고수평(0.86),유조우간암적조기진단여사사.
Objective To investigate the diagnostic value of serum glypican-3 (GPC3) combined with alpha-fetoprotein (AFP) versus alpha fetoprotein alone for hepatocellular carcinoma.Methods A comprehensive electronic search and additional manual tracking were performed to retrieve published studies addressing the diagnostic value of GPC3 combined with AFP compared with AFP alone for liver cancer.The retrieved literatures were screened and selected according to pre-determined inclusion and exclusion criteria.Data were extracted and analyzed using the software STATA12.0.Summary receiver operating characteristic curves were used to compare test performance of the two.Results Nineteen studies met the inclusion criteria and were included into this study.Heterogeneity existed among these studies,but it was not possibly caused by the threshold effect.Therefore,we used the random effect model for quantitative analysis.The pooled accuracy indicator,sensitivity and specificity were 0.61 and 0.93 for AFP alone,and 0.84 and 0.86 for GPC3 combined with AFP,respectively.The area under summary receiver operating characteristics curve and Q index were 0.81 and 0.75 for AFP alone,and 0.91 and 0.85 for GPC3 combined with AFP.Conclusious GPC3 combined with AFP significantly improved the diagnostic sensitivity,and its specificity remained at a high level (0.86),indicating that the combined use of GPC3 and AFP is helpful for screening and early diagnosis of liver cancer.