Prostate cancer antigen 3 test for prostate biopsy decision: a systematic review and meta analysis
Prostate cancer antigen 3 test for prostate biopsy decision: a systematic review and meta analysis
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DOI：
10.3760/cma.j.issn.0366-6999.20132519
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发表时间：
2014-05-05
影响因子：
6.1
通讯作者：
Mou Chan
中科院分区：
文献类型：
--
作者：
Luo Yong;Gou Xin;Mou Chan
背景前列腺特异性抗原（PSA）在前列腺癌（PCa）早期干预的特异性并不令人满意。前列腺癌抗原3 （PCA3）可能比PSA更准确地预测前列腺癌早期检测的活检结果。我们系统地回顾了文献，随后进行了荟萃分析。方法检索Embase、Medline、Web of Science、NCBI、PubMed、CNKI等数据库及2013年4月前发表的卫生技术评价机构文献。关键词为“前列腺肿瘤”、“前列腺”、“前列腺癌”、“癌”、“肿瘤”、“PCa”，自由术语为“upm3”、“pca3”、“dd3”、“aptinnapca 3”、“前列腺癌抗原3”。所有患者均为成年人。干预措施是检测尿液样本中的PCA3以诊断前列腺癌。我们根据QUADAS标准检查质量，收集数据，并进行荟萃分析以综合结果。选取了24项中等至高质量的诊断试验研究。结果灵敏度在46.9% ~ 82.3%之间；特异性为55% ~ 92%；阳性预测值为39.0% ~ 86.0%；阴性预测值为61.0% ~ 89.7%。meta分析显示研究之间存在异质性。总体敏感性值为0.82 (95% CI 0.72-0.90)；特异性为0.962 (95% CI 0.73-0.99)；阳性似然比为2.39 (95% CI 2.10-2.71)；负似然比为0.51 (95% CI 0.46 ~ 0.86)；诊断优势比为4.89 (95% CI 3.94-6.06)；SROC曲线的AUC为0.744 1。结论PCA3可用于前列腺癌的早期诊断，避免不必要的活检。
Background The specificity for early interventions of prostate-specific antigen (PSA) in prostate cancer (PCa) is not satisfactory. It is likely that prostate cancer antigen 3 (PCA3) can be used to predict biopsy outcomes more accurately than PSA for the early detection of PCa. We systematically reviewed literatures and subsequently performed a meta-analysis.Methods A bibliographic search in the database of Embase, Medline, Web of Science, NCBI, PubMed, CNKI, and those of health technology assessment agencies published before April 2013 was conducted. The key words used were "prostatic neoplasms", "prostate", "'prostate,' 'carcinoma' or 'cancer' or 'tumor', or 'PCa," and free terms of "upm3", "pca3", "dd3", "aptinnapca 3", and "prostate cancer antigen 3". All patients were adults. The intervention was detecting PCA3 in urine samples for PCa diagnosis. We checked the quality based on the QUADAS criteria, collected data, and developed a meta-analysis to synthesize results. Twenty-four studies of diagnostic tests with moderate to high quality were selected.Results The sensitivity was between 46.9% and 82.3%; specificity was from 55% to 92%; positive predictive value had a range of 39.0%-86.0%; and the negative predictive value was 61.0%-89.7%. The meta-analysis has heterogeneity between studies. The global sensitivity value was 0.82 (95% CI 0.72-0.90); specificity was 0.962 (95% CI 0.73-0.99); positive likelihood ratio was 2.39 (95% CI 2.10-2.71); negative likelihood ratio was 0.51 (95% CI 0.46-0.86); diagnostic odds ratio was 4.89 (95% CI 3.94-6.06); and AUC in SROC curve was 0.744 1.Conclusion PCA3 can be used for early diagnosis of PCa and to avoid unnecessary biopsies.