摘要
目的系统评价总前列腺特异性抗原(t-PSA)为4～10ng/mL时血清游离前列腺特异性抗原/总前列腺特异性抗原(f/tPSA)用于前列腺癌诊断的临床价值。方法计算机检索中国生物医学文献数据库(1999～2009)、中文科技期刊全文数据库(1999～2009)、中国期刊全文数据库(1999～2009)和万方数据库(1999～2009),并手工检索相关期刊,全面收集f/tPSA诊断前列腺癌的中文文献,按QUADAS条目对纳入研究进行质量评价。采用MetaDisc1.4软件检验各研究间的异质性,并按f/tPSA临界值0.1、0.15、0.2、0.25及0.3分组,进行Meta分析。结果最终纳入18个研究。异质性检验提示无阈值效应,但存在其他因素导致的异质性,按随机效应模型做Meta分析。结果显示f/tPSA临界值为0.15组的敏感度与特异度均较好,SROC曲线下面积及Q*指数分别为0.8835和0.8140,明显高于其他组。结论 f/tPSA比值是前列腺癌诊断灰区(t-PSA为4～10ng/mL)的较好诊断指标,以0.15作为临界值较为适合。
Objective To systemically evaluate the accuracy off/t-PSA for diagnosing prostate cancer with a t-PSA level of 4-10ng/mL through meta-analysis. Methods A literature search of CBM, VIP, CNKI and Wanfang Data from 1999 to 2009 was performed. Related journals were also searched manually. Two reviewers independently assessed trial quality according to QUADAS items. Heterogenous studies and meta-analysis were conducted by Meta-Disc1.4 software. The analysis was based on different critical values off/t-PSA （0.1, 0.15, 0.2, 0.25, and 0.3）. Results Total 18 studies in-volving 2217 subjects were included. No threshold effect was found. But there was heterogeneity due to other factors. The meta–analysis showed that, the sensitivity off/t-PSA with the critical value of 0.15 for the diagnosis of prostate cancer with at-PSA level of 4-10ng/mL was 75% （95%CI 70%-79%）, and the speci city was 81% （95%CI 78%-84%）. The area under SROC curve was 0.8835, and the Q index was 0.8140. Conclusion The f/t-PSA is a better index for diagnosing prostate cancer with t-PSA levels between 4 and 10ng/mL. And it is reasonable to consider 0.15 as a more suitable critical value.
出处
《中国循证医学杂志》
CSCD
2010年第10期1164-1168,共5页
Chinese Journal of Evidence-based Medicine
