Accuracy Evaluation and Comparison of 14 Diagnostic Markers for Nasopharyngeal Carcinoma: A Meta-Analysis.
Accuracy Evaluation and Comparison of 14 Diagnostic Markers for Nasopharyngeal Carcinoma: A Meta-Analysis.
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鼻咽癌14个诊断标志物准确性评价及比较：Meta分析
DOI：
10.3389/fonc.2020.01779
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发表时间：
2020
影响因子：
4.7
通讯作者：
Yi X
中科院分区：
文献类型：
--
作者：
Feng Y;Xia W;He G;Ke R;Liu L;Xie M;Tang A;Yi X
本研究的目的是收集已发表的研究，并比较不同标志物对鼻咽癌(NPC)诊断的准确性。计算机检索PubMed/MEDLINE、EMBASE、Cochrane Library、CNKI、万方等相关文献，直至2020年4月29日。使用修订的诊断准确性研究质量评估(QUADAS-2)工具来评估研究的方法学质量。用双因素混合效应模型结合诊断指标的灵敏度、特异度、阳性似然比(PLR)、阴性似然比(NLR)、诊断优势比(DOR)和曲线下面积(AUC)值来比较它们的诊断准确性。我们通过Meta回归分析了异质性。总共纳入了101篇文章的244条记录，总共有49,432名研究对象(13,109例病例和36,323名对照)。非侵袭性鼻咽刷检(EBV-DNA刷检)中EA-Ig G、Zta-Ig G和EB病毒(EBV)DNA载量具有较高的敏感性和特异性，EBNA1-Ig G和VCA-Ig G仅有较高的敏感性，EBNA1-Ig A、VCA-Ig A、RTA-Ig G、Zta-Ig A、HSP70和血清唾液酸(SA)只有较高的特异性。EA-IgA的二元混合效应模型具有显著的阈值效应。Meta回归分析显示，民族影响EBNA1-IgA、EBNA1-Ig G、VCA-Ig A和EBVDNA载量，检测方法影响EBNA1-Ig G，出版年限影响VCA-Ig A，样本大小影响RTA-Ig G。VCA-Ig A和RTA-Ig G有显著的发表偏倚(P<；0.05)。Ea-Ig G、Zta-Ig G和EBV-DNA刷检是诊断鼻咽癌的良好指标。诊断的准确性受发表年份、样本量、测试方法和种族的影响。
The aim of the present study was to collect published studies and compare the diagnostic accuracy of different markers for nasopharyngeal carcinoma (NPC). We systematically searched PubMed/MEDLINE, EMBASE, Cochrane Library, CNKI, and Wanfang for relevant studies until April 29, 2020. The revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to evaluate the methodological quality of the studies. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) values of the diagnostic markers were combined by a bivariate mixed effect model to compare their diagnostic accuracy. We explored heterogeneity through meta-regression. In total, 244 records from 101 articles were included, with 49,432 total study subjects (13,109 cases and 36,323 controls). EA-IgG, Zta-IgG, and Epstein–Barr virus (EBV) DNA load in non-invasive nasopharyngeal brushings (EBV-DNA brushings) have both high sensitivity and specificity, EBNA1-IgG and VCA-IgG have only high sensitivity, and EBNA1-IgA, VCA-IgA, Rta-IgG, Zta-IgA, HSP70, and serum sialic acid (SA) have only high specificity. The bivariate mixed effect model of EA-IgA had a significant threshold effect. Meta-regression analysis showed that ethnicity affected EBNA1-IgA, EBNA1-IgG, VCA-IgA, and EBV DNA load in plasma, test methods affected EBNA1-IgG, publication year affected VCA-IgA, and sample size affected Rta-IgG. There was significant publication bias for VCA-IgA and Rta-IgG (P < 0.05). EA-IgG, Zta-IgG, and EBV-DNA brushings are good diagnostic markers for NPC. The diagnostic accuracy was influenced by publication year, sample size, test methods, and ethnicity.
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