Combined Detection of CA125, CA19-9, and CEA in the Diagnosis of Ovarian Cancer: A Meta Analysis
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摘要:
目的 评价联合检测血清CA125、CA199、CEA在卵巢癌诊断中的价值。 方法 计算机检索Pubmed、CBMdisc、CNKI、维普等数据库, 收集关于卵巢癌诊断中联合检测CA125、CA199、CEA的文献。采用Meta-DiSc 14.0、Stata10.0进行Meta分析。 结果 按照统一的纳入标准和排除标准获得12篇文献。结果显示在卵巢癌诊断中, 联合检测CA 125、CA199、CEA的灵敏度(SE)、特异度(SP)、诊断比值比(DOR)、SROC曲线下面积(AUC)、Q指数分别为0.90(0.88~0.93)、0.83(0.80~0.86)、39.75(22.58~69.97)、0.953、0.895。单独检测CA125的SE、SP、DOR、AUC、Q指数分别为0.73(0.69~0.77)、0.88(0.86~0.91)、17.45(9.95~30.48)、0.804、0.739。两种检测方式的诊断效能比较差异有统计学意义(Z=4.859, P < 0.05)。 结论 卵巢癌的临床辅助诊断中, 与单独检测CA125比较, 联合检测CA125、CA199、CEA的判别能力较强、准确率较高, 可提高诊断效能。 Abstract:Objective The current work aims to evaluate the importance of combined detection of the tumor markers CA125, CA19-9, and CEA in the diagnosis of ovarian cancer. Methods A computerized literature search was carried out in the databases of Pubmed, CBMdisc, CNKI, and VIP, among others, to collect articles regarding the diagnostic value of combined detection of the cancer markers CA125, CA19-9, and CEA in the diagnosis of ovarian cancer.Meta DiSc14.0 and Stata10.0 software were used to conduct the meta-analysis. Results A total of 12 literatures were obtained in the current study with the unified inclusion and exclusion criteria.The results showed that the sensitivity(SE), specificity(SP), diagnostic odds ratio(DOR), area under curve of SROC curve(AUC), and Q* index of the tumor markers CA125, CA19-9, and CEA were 0.90(0.88-0.93), 0.83(0.80-0.86), 39.75(22.58-69.97), 0.95 and 0.89, respectively, in the diagnosis of ovarian cancer.In contrast, the indices of SE, SP, DOR, AUC, and Q* of the marker CA125 that was detected alone were 0.73(0.69-0.77), 0.88(0.86-0.91), 17.45(9.95-30.48), 0.804, and 0.739 respectively.The result of the Z test has proven that significant differences exist between the two methods in diagnosing ovarian cancer(Z=4.859, P < 0.05). Conclusion The combined detection of CA19-9, CA125, and CEA in the clinically auxiliary diagnosis of ovarian cancer may provide more competent and valuable laboratory proof compared with solitary detection of CA125. -
Key words:
- CA125 /
- CA19-9 /
- CEA /
- Ovarian cancer /
- Meta analysis
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表 1 纳入文献的基本信息
Table 1. The information about the inclusion literatures performed by Meta analysis
表 2 单独检测CA125和联合检测CA125、CA199、CEA的Meta分析结果
Table 2. The results of the detection of CA125 and the combined detection of CA125, CA199 and CEA in Meta analysis
表 3 单独检测CA125和联合检测CA125、CA199、CEA异质性来源分析
Table 3. Heterogeneity of the detection of CA125 and the combined detection of CA125, CA199 and CEA in Meta analysis
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[1] 廖遇平, 姜武忠, 主编. 实用肿瘤综合治疗手册[M]. 长沙: 湖南科学技术出版社, 2006: 463-474. [2] Dasl PM, Bast JrRC. Early detection of ovarian cancer[J]. Biomark Med, 2008, 2(3): 291-303. doi: 10.2217/17520363.2.3.291 [3] 邢桂芝, 周秀艳. 应用ROC曲线评价血清CA125、CA199和CEA对卵巢癌的诊断价值[J]. 现代预防医学, 2009, 36(18): 3592-3592. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF200918085.htm [4] 罗晓红, 段朝晖, 潘昆贻, 等. 血清CA125、CA199及CEA联合检测在卵巢肿瘤诊断中的价值[J]. 临床和实验医学杂志, 2006, 5(7): 878-879. doi: 10.3969/j.issn.1671-4695.2006.07.015 [5] 邵丽佳, 徐瑞龙, 胡轶. 血清CA125、CA199、CEA单检及联检对诊断卵巢癌的临床价值[J]. 放射免疫学杂志, 2007, 20(1): 92-93. doi: 10.3969/j.issn.1008-9810.2007.01.052 [6] 宋小龙, 王国申, 罗俊敏, 等. 血清CA125联合CA199、CEA检测在卵巢癌诊断中的应用价值[j]. 河南大学学报(医学版), 2007, 26(3): 70-71. [7] 罗贤波. CA125、CA19-9、CEA联合检测在卵巢癌诊断中的价值[J]. 中国医疗前沿, 2009, 4(6): 77-78. doi: 10.3969/j.issn.1673-5552.2009.06.068 [8] 黄芳. CA125、CA199与CEA联合检测对卵巢癌的诊断价值[J]. 广西医学, 2010, 32(4): 424-425. doi: 10.3969/j.issn.0253-4304.2010.04.016 [9] 李林, 廖嘉煦. 血清CEA、CA19-9、CA125联检对卵巢癌的诊断价值[J]. 现代临床医学, 2010, 36(2): 122-124. doi: 10.3969/j.issn.1673-1557.2010.02.022 [10] 蒲泽晏, 刘方久, 刘友迎. 卵巢癌诊断中联合检测CA125、CEA、CA19-9的实验研究[J]. 华西医学, 2010, 25(10): 1879-1880. https://www.cnki.com.cn/Article/CJFDTOTAL-HXYX201010056.htm [11] 钱明, 袁君君, 王晓鸿, 等. CA125、CA199、CEA联合检测对卵巢上皮癌诊断及疗效的价值[J]. 中国实用医药, 2010, 5(26): 53-54. doi: 10.3969/j.issn.1673-7555.2010.26.031 [12] 刘露, 张木坤, 陈景连, 等. 血清CA125、CA199与CEA联合检测在卵巢癌诊断中的意义[J]. 重庆医学, 2011, 40(24): 2423-2424. doi: 10.3969/j.issn.1671-8348.2011.24.012 [13] 王瑾. 三种肿瘤标志物联合检测在卵巢癌诊断中的实用价值[J]. 中国煤炭工业医学杂志, 2011, 14(7): 985-986. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMGY201107020.htm [14] 于波. 血清肿瘤标志物CEA、CA125和CA19-9联合检测在卵巢癌诊断中的价值[J]. 滨州医学院学报, 2011, 34(4): 294-295. doi: 10.3969/j.issn.1001-9510.2011.04.019 [15] 张凤兰. 血清CEA、CA125、CA199联检在卵巢癌诊断中的应用价值[J]. 中国误诊学杂志, 2011, 11(19): 4646-4647. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWZX201119096.htm [16] Gupta D, Lis CG. Role of CA125 in predicting ovarian cancer survival - a review of the epidemiological literature[J]. J Ovarian Res, 2009, 2: 13. doi: 10.1186/1757-2215-2-13 [17] 李小平, 陈斌鸿, 陈社安. 血清CA153、CA125、CA199与CEA检测在乳腺癌诊断中的应用[J]. 广西医学, 2004, 26(7): 975-977. doi: 10.3969/j.issn.0253-4304.2004.07.036 [18] 刘冬妍, 董艳娥, 郭淑光, 等. 比较血清CEA、CA199、CA125、CA724对卵巢癌临床诊断及疗效观察的价值[J]. 辽宁医学杂志, 2002, 16(1): 17-18. doi: 10.3969/j.issn.1001-1722.2002.01.010 [19] 杨克虎, 主编. 系统评价指导手册[M]. 北京: 人民卫生出版社, 2010: 179-213.