目的用meta分析的方法评价血清α-L-岩藻糖苷酶(AFU)在原发性肝癌(PHC)诊断中的价值。方法检索Cochrane Library、Pub Med、web of knowledge(Medline、BIOSIS Previews)、Springer link、Science Direct数据库,检索时间为1997年1月至2013年12月。中国生物医学文献数据库(CBM)、中国知网、万方、重庆维普等数据库,检索时间为19841月年至2013年12月。检索语言限定为中文和英文。收集研究血清AFU对PHC诊断价值的相关文献,对符合纳入标准的文献进行质量评价,采用meta-Disc 1.4软件进行分析,综合评价血清AFU在原发性肝癌诊断中的价值。结果共纳入20篇文献(中文15篇,英文5篇)。分析病例组2 114例,对照组5 718例。对入选20篇文献进行异质性检验,提示所纳入文献具有非阈值效应引起的异质性,因此选用随机效应模型进行meta分析。汇总灵敏度为0.77;汇总特异度为0.87;汇总阳性似然比为5.37;汇总阴性似然比为0.28;诊断比值比为20.47;受试者工作曲线(SROC)曲线下面积为0.87。结论血清AFU在PHC的诊断中具有较高的灵敏度和特异度,对其临床诊断具有较高的价值。
Objective To evaluate the diagnostic value of serum α-L-fucosidase (AFU) in primary hepatic carcinoma(PHC) by using the meta analysis method. Methods The databases of Cochrane Library,PubMed,web of knowledge(Medline, BIOSIS Previews) ,Springer link and Science Direct were retrieved from January 1997 to December 2013. The domestic databases of CBMdisc (Chinese BioMedical Literature on disc), CNKI, Wangfang and VIP(VIP Database for Chinese Technical Periodicals) were retrieved from January 1984 to December 2013. Retrieval languages were limited to Chinese and English. The related literatures on the study of serum AFU diagnostic value for PHC were collected and the included studies meeting the inclusion criteria were performed the quality assessment. The meta-Disc 1.4 software was adopted to conduct the analysis for comprehensively evaluating serum AFU value in the diagnosis of PHC. Results 20 articles were included (15 articles in Chinese and 5 articles in English). A total of 2 114 cases in the patients groups and 5 718 cases in the control groups were analyzed. The heterogeneity test was carried out on the in- cluded 20 articles,suggesting that the heterogeneity of the included studies was caused by the non-threshold effect, so the random effects model was selected for conducting the recta-analysis. And the pooled sensitivity was 0.77, the pooled specificity was 0.87, the pooled positive likelihood ratio was 5.37, the pooled negative likelihood ratio was 0.28, the pooled diagnostic odds ratio was 20. 47 and the SROC area under the curve(AUC) was 0.87. Conclusion Serum AFU has highly sensitivity and specificity for the diagnosis of PHC and has reference value for its clinical diagnosis.