Does risk for ovarian malignancy algorithm excel human epididymis protein 4 and CA125 in predicting epithelial ovarian cancer: a meta-analysis.
Does risk for ovarian malignancy algorithm excel human epididymis protein 4 and CA125 in predicting epithelial ovarian cancer: a meta-analysis.
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卵巢恶性肿瘤风险算法在预测上皮性卵巢癌方面是否优于人类附睾蛋白 4 和 ca125：一项荟萃分析。
DOI：
10.1186/1471-2407-12-258
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发表时间：
2012-06-19
期刊：
影响因子：
3.8
通讯作者：
Chen M
中科院分区：
文献类型：
--
作者：
Li F;Tie R;Chang K;Wang F;Deng S;Lu W;Yu L;Chen M
卵巢癌风险评估算法（ROMA）和人附睾蛋白4（HE 4）似乎是上皮性卵巢癌（EOC）的有希望的预测因子，然而，在ROMA、HE 4和CA 125之间的诊断性能比较中存在相互矛盾的结果。检索远程数据库（MEDLINE/PUBMED、EMBASE、Web of Science、Google Scholar、科克伦图书馆和ClinicalTrials.gov）和全文参考书目中的相关摘要。所有纳入的研究均采用QUADAS-2（诊断准确性研究质量评估-2）进行了密切评估。系统评价ROMA对EOC的预测价值，并在同一人群中比较ROMA、HE 4和CA 125的预测性能。采用双变量模型总结灵敏度、特异性、DOR（诊断比值比）、LR ±（阳性和阴性似然比）和AUC（受试者工作特征曲线下面积）。采用亚组分析和敏感性分析探讨异质性。从11个研究中检索到7792个测试数据。ROMA预测EOC的总体估计值为：灵敏度（0.89，95%CI 0.84-0.93）、特异性（0.83，95%CI 0.77-0.88）和AUC（0.93，95%CI 0.90-0.95）。比较HE 4与CA 125的EOC预测值发现，特异性：HE 4（0.93，95%CI 0.87-0.96）> CA 125（0.84，95%CI 0.76-0.90）; AUC：CA 125（0.88，95%CI 0.85-0.91）> HE 4（0.82，95%CI 0.78-0.85）。HE 4与CA 125的OC预测值比较发现，AUC：CA 125（0.89，95%CI 0.85-0.91）> HE 4（0.79，95%CI 0.76-0.83）。EOC预测的三种测试之间的比较发现，灵敏度：ROMA（0.86，95%CI 0.81-0.91）> HE4（0.80，95%CI 0.73-0.85）;特异性：HE 4（0.94，95%CI 0.90-0.96）> ROMA（0.84，95%CI 0.79-0.88）> CA 125（0.78，95%CI 0.73-0.83）。ROMA有助于鉴别卵巢上皮性癌和良性盆腔包块。对于EOC或OC预测，HE 4并不比CA 125好。ROMA是有希望取代CA 125的上皮性卵巢癌的预测因子，但其利用需要进一步探索。
Risk for Ovarian Malignancy Algorithm (ROMA) and Human epididymis protein 4 (HE4) appear to be promising predictors for epithelial ovarian cancer (EOC), however, conflicting results exist in the diagnostic performance comparison among ROMA, HE4 and CA125. Remote databases (MEDLINE/PUBMED, EMBASE, Web of Science, Google Scholar, the Cochrane Library and ClinicalTrials.gov) and full texts bibliography were searched for relevant abstracts. All studies included were closely assessed with the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2). EOC predictive value of ROMA was systematically evaluated, and comparison among the predictive performances of ROMA, HE4 and CA125 were conducted within the same population. Sensitivity, specificity, DOR (diagnostic odds ratio), LR ± (positive and negative likelihood ratio) and AUC (area under receiver operating characteristic-curve) were summarized with a bivariate model. Subgroup analysis and sensitivity analysis were used to explore the heterogeneity. Data of 7792 tests were retrieved from 11 studies. The overall estimates of ROMA for EOC predicting were: sensitivity (0.89, 95% CI 0.84-0.93), specificity (0.83, 95% CI 0.77-0.88), and AUC (0.93, 95% CI 0.90-0.95). Comparison of EOC predictive value between HE4 and CA125 found, specificity: HE4 (0.93, 95% CI 0.87-0.96) > CA125 (0.84, 95% CI 0.76-0.90); AUC: CA125 (0.88, 95% CI 0.85-0.91) > HE4 (0.82, 95% CI 0.78-0.85). Comparison of OC predictive value between HE4 and CA125 found, AUC: CA125 (0.89, 95% CI 0.85-0.91) > HE4 (0.79, 95% CI 0.76-0.83). Comparison among the three tests for EOC prediction found, sensitivity: ROMA (0.86, 95%CI 0.81-0.91) > HE4 (0.80, 95% CI 0.73-0.85); specificity: HE4 (0.94, 95% CI 0.90-0.96) > ROMA (0.84, 95% CI 0.79-0.88) > CA125 (0.78, 95%CI 0.73-0.83). ROMA is helpful for distinguishing epithelial ovarian cancer from benign pelvic mass. HE4 is not better than CA125 either for EOC or OC prediction. ROMA is promising predictors of epithelial ovarian cancer to replace CA125, but its utilization requires further exploration.
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