专题研究(Monographic Study)

循环肿瘤细胞对胰腺癌诊断价值的Meta分析

Published at: 2017年第26卷第3期

吴斌 1 , 陈敏捷 1 , 陈飞 2 , 吴绍汉 2 , 王晓光 2 , 钟征翔 2
1 泰山医学院 研究生院,山东 泰安 271000
2 浙江省嘉兴市第二医院 肝胆外科,浙江 嘉兴 314000
通讯作者 征翔 钟 Email: 13505739209@139.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2017.03.002
基金:
浙江省嘉兴市社会发展计划基金资助项目 2016AY23057

摘要

目的:通过Meta分析系统评价外周循环肿瘤细胞(CTCs)在胰腺癌患者中的诊断中的价值。方法:计算机检索多个国内外数据库,收集已发表关于CTCs在胰腺癌患者与非胰腺癌人群中检测的研究,检索起止时间均为建库至2016年8月31日。按照纳入标准筛选文献、提取资料和质量评价后,采用Metadisc 1.4和Stata 12.0软件对纳入研究进行Meta分析。结果:共纳入19篇文献,包含693例胰腺癌患者和406例非胰腺癌对照。采用随机效应模型进行统计量,得到CTCs检测对胰腺癌检出的合并敏感性为0.67(95% CI=0.63~0.60),合并特异性为0.94(95% CI=0.91~0.96),合并诊断优势比DOR为50.47(95% CI=20.13~126.55),合并诊断阳性似然比和阴性似然比分别为11.15(95% CI=5.42~22.95)、0.36(95% CI=0.28~0.45);总受试者工作特征曲线下面积为0.93,Q*值为0.03,诊断性试验Deek漏斗图显示存在发表偏倚。结论:目前CTCs尚不足以单独作为胰腺癌早期诊断指标,但可作为胰腺癌诊断方法的重要补充。


Value of circulating tumor cells for diagnosis of pancreatic cancer: a Meta-analysis

Abstract

Objective: To systematically evaluate the diagnostic value of circulating tumor cells (CTCs) in patients with pancreatic cancer through Meta-analysis. Methods: The studies regarding detection of CTCs in pancreatic cancer patients and non-pancreatic cancer subjects were collected through searching several national and international databases. The retrieval time was from inception of the database to 31 August 2016. After screening for inclusion criteria, data extraction and quality assessment, Meta-analysis was performed by the Metadisc 1.4 and Stata 12.0 software. Results: A total of 19 articles were selected, involving 693 pancreatic cancer patients and 406 non-pancreatic controls. Pooling the data using the random effect model showed that the pooled sensitivity and specificity of the CTCs for detection of pancreatic cancer was 0.67 (95% CI=0.63–0.60) and 0.94 (95% CI=0.91–0.96), the pooled diagnostic odds ratio was 50.47 (95% CI=20.13–126.55), and the pooled positive likelihood ratio and negative likelihood ratio was 11.15 (95% CI=5.42–22.95) and 0.36 (95% CI=0.28–0.45), respectively. The area under the curve of the summary receiver operating characteristic curve was 0.93 with a Q* value of 0.03. Diagnostic Test Deek’s funnel plot for diagnostic test demonstrated the presence of publication bias. Conclusion: CTCs detection is incompetent to be used dependently as an early diagnosis indicator for pancreatic cancer, while it may probably serve as a supplementary index for diagnosis of pancreatic cancer.


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引用

引用本文: 斌 吴, 敏捷 陈, 飞 陈, 绍汉 吴, 晓光 王, 征翔 钟. 循环肿瘤细胞对胰腺癌诊断价值的Meta分析[J]. 中国普通外科杂志, 2017, 26(3): 271-280.
Cite this article as: WU Bin, CHEN Minjie, CHEN Fei, WU Shaohan, WANG Xiaoguang, ZHONG Zhengxiang . Value of circulating tumor cells for diagnosis of pancreatic cancer: a Meta-analysis[J]. Chin J Gen Surg, 2017, 26(3): 271-280.