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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图 2 联合检测的DOR森林图
Figure 2. Forest plots of DOR of the combined detection of CA125, CA199 and CEA
图 4 联合检测CA125、CA199、CEA的SROC曲线
Figure 4. The curve SROC of the combined detection of CA125, CA199 and CEA
图 5 单独检测CA125的DOR Meta分析的剪补
A：剪补前：合并DOR（95%CI）：23.45（13.58~40.51）；B：剪补后：合并DOR（95%CI）：17.45（9.95~30.48）
Figure 5. Unfilled and filled funnel plot of the detection of CA125
图 6 联合检测CA125、CA199、CEA的DOR Meta分析的剪补
A：剪补前：合并DOR（95%CI）：53.98（30.75~94.77）；B：剪补后：合并DOR（95%CI）：39.75（22.58~69.97）
Figure 6. Unfilled and filled funnel plot of the combined detection of CA125, CA199 and CEA
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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