Diagnostic and prognostic value of carcinoembryonic antigen in pancreatic cancer: a systematic review and meta-analysis.
Diagnostic and prognostic value of carcinoembryonic antigen in pancreatic cancer: a systematic review and meta-analysis.
复制标题
DOI：
10.2147/ott.s145708
复制
发表时间：
2017
影响因子：
4
通讯作者：
Yu X
中科院分区：
文献类型：
--
作者：
Meng Q;Shi S;Liang C;Liang D;Xu W;Ji S;Zhang B;Ni Q;Xu J;Yu X
癌胚抗原（CEA）是最广泛使用的肿瘤标志物之一，在30%-60%的胰腺癌患者中升高。尽管糖链抗原19-9（CA 19 -9）是胰腺癌最重要的血清标志物，但CEA的诊断和预后价值正逐渐被认识。检索MEDLINE、EMBASE和Web of Science数据库中截至2017年1月发表的相关文献。使用Meta-Disc软件合并诊断准确性变量。使用Stata软件计算和分析预后数据的合并风险比（HR）。共有3，650名参与者参加了19项研究，符合我们的入选标准。基于CEA的面板的合并灵敏度、特异性、阳性似然比和阴性似然比分别为0.45（95%置信区间[CI]，0.41-0.50）、0.89（95% CI，0.86-0.91）、5.39（95% CI，3.16-9.18）和0.55（95% CI，0.41-0.72）。基于CEA的组的曲线下面积（AUC，0.90）和Q值（0.84）表明与单独的CEA或CA 19 -9相比，诊断准确性显著更高。此外，高CEA水平与总体生存率差之间也存在显著相关性（HR，1.43; 95%CI，1.31-1.56）。Meta分析结果表明，血清CEA水平升高作为CA 19 -9的重要补充，对胰腺癌患者的临床诊断和预后判断具有重要意义。
Carcinoembryonic antigen (CEA) is one of the most widely used tumor markers and is increased in 30%–60% of patients with pancreatic cancer. Although carbohydrate antigen 19-9 (CA19-9) is the most important serum biomarker in pancreatic cancer, the diagnostic and prognostic value of CEA is gradually being recognized. The MEDLINE, EMBASE, and Web of Science databases were searched for related literature published until January 2017. Diagnostic accuracy variables were pooled using the Meta-Disc software. The pooled hazard ratios (HRs) for prognostic data were calculated and analyzed using Stata software. A total of 3,650 participants enrolled in 19 studies met our inclusion criteria. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of a CEA-based panel were 0.45 (95% confidence interval [CI], 0.41–0.50), 0.89 (95% CI, 0.86–0.91), 5.39 (95% CI, 3.16–9.18), and 0.55 (95% CI, 0.41–0.72), respectively. The area under the curve (AUC, 0.90) and Q-value (0.84) of the CEA-based panel indicated a significantly higher diagnostic accuracy compared with CEA or CA19-9 alone. Moreover, there was also a significant association between high levels of CEA and worse overall survival (HR, 1.43; 95% CI, 1.31–1.56). Our meta-analysis indicated that elevated serum CEA level, as a vital supplementary to CA19-9, can play an important role in the clinical diagnosis of pancreatic cancer patients and predict poor prognosis.