【摘要】 目的探讨端粒酶活性TRAP-ELISA检测法对恶性胸腔积液(MPE)的诊断效能.方法检索国内外各类大型数据库中近十余年发表的有关端粒酶活性TRAP-ELISA检测法与恶性胸腔积液(MPE)关系的前瞻性和回顾性研究为基础文献,对其中的英文文献和中文文献进行系统评价,应用Meta-DiSc统计软件整合Meta分析随机效应模型进行定量综合分析,绘制汇总受试者工作特征曲线,以探讨此次试验的总体诊断特性.结果按照选择标准最终有18项独立研究纳入本次meta分析.采用随机效应模型计算,合并OR为57.52(95%CI:31.50～105.05).合并总灵敏度为0.84(95%CI0.81～0.87),特异度为0.92(95%CI:0.89～0.93),灵敏度与特异度最大交点的均值为0.9087,AUC为0.9628,合并PLR为9.15(95%CI:6.53～12.82),而NLR为0.18(95%CI:0.12～0.26)>0.1.此次试验所得汇总受试者工作特征曲线显示胸水端粒酶活性TRAP-ELISA法测定诊断MPE效能较高.结论端粒酶活性TRAP-ELISA检测法可以作为筛查MPE或鉴别胸腔积液的一个重要指标,但其假阴性问题存在,还不足以作为单一应用来诊断MPE.更多还原

【Abstract】 Objective To explore the diagnostic value of the telomerase assay with ELISA-based TRAP in malignant pleural effusion(MPE).Methods We searched the literatures of researches about the detection of telomerase activity with ELISA-based TRAP assay and its relationship with malignant pleural effusion(MPE)published in recent ten years,and systematically evaluated both English and Chinese literatures.A combination of Meta-DiSc statistical soft ware and Meta analysis random effective model was applied to comprehensive quantitative analysis.We discussed the overall diagnosis features of this assay by drawing characteristic curves.Results According to selecting standards,18 independent studies were finally selected in this meta analysis.Calculated with random effective model,comprehensive OR was 57.52(95%CI:31.50～105.05),comprehensive sensitivity was 0.84(95% CI:0.81～0.87),specificity was 0.92(95%CI:0.89～The 0.93),average value of maximum intersection point of sensitivity and specificity was 0.9087,AUC was 0.9628,combined PLR was 9.15(95%CI:6.53～12.82),and NLR was 0.18(95%CI:0.12～0.26)>0.1.The characteristic curves of the examination showed that detection of telomerase activity with ELISA-based TRAP assay has relatively high efficacy in determining and diagnosing MPE.Conclusions The detection of telomerase activity with ELISA-based TRAP assay can be used as an important index to screen MPE or identify pleural effusion.However,due to its pseudo-negative possibility,it is not enough to be used as a single method to diagnose MPE.更多还原