【摘要】 目的卵巢癌治疗后复发和转移是影响患者预后及生存最重要的因素,血清CA125监测在卵巢癌术后随访中具有重要的价值。采用Meta分析的方法综合评估化学发光免疫技术测定血清CA125诊断卵巢癌复发及转移的价值。方法计算机系统检索PubMed、Embase、Cochrane、Web of Science、中国知网、中国生物医学文献、重庆维普和万方数据库中化学发光免疫技术测定血清CA125诊断卵巢癌复发及转移的研究,检索时间自数据库建立截止至2018-01。2位分别从事检验医学和循证医学的研究人员按照纳入和排除标准严格进行文献筛选、资料提取分析,采用QUADAS-2条目评价纳入研究的质量后,使用Stata 12.0进行Meta汇总分析,计算合并的敏感度（sentivity,Sen）、特异度（specificity,Spe）、阳性似然比（positive likelihood ratio,PLR）、阴性似然比（negative likelihood ratio,NLR）、诊断比值比（diagnostic odds ratio,DOR）,绘制综合受试者工作特征（summary receiver operating characteristic,SROC）曲线并计算曲线下面积（area under curve,AUC）以评价CA125诊断卵巢癌复发及转移的价值。结果共纳入原始研究文献24篇及1 717例患者。Meta分析显示,血清CA125诊断卵巢癌复发及转移的Sen合并=0.72（95%CI为0.65⁰.79）,Spe_合并=0.90（95%CI为0.83⁰.94）,PLR合并=7.26（95%CI为4.13¹2.20）,NLR合并=0.31（95%CI为0.24⁰.39）,DOR合并=23.51（95%CI为12.71⁴3.48）,AUC=0.87（95%CI为0.84⁰.90）。亚组分析结果显示,血清CA125对诊断女性年龄≥53岁（AUC=0.88,95%CI为0.85⁰.91）的卵巢癌复发及转移的价值明显高于年龄<53岁（AUC=0.72,95%CI为0.68⁰.76）的女性,差异有统计学意义,P=0.002。结论化学发光免疫技术测定血清CA125对诊断卵巢癌复发及转移具有较高的诊断及鉴别诊断价值,尤其是对年龄≥53岁的女性。更多还原

【Abstract】 OBJECTIVE Recurrent and metastatic of ovarian cancer are the most important factors concercing patients’ prognosis and survival,and CA125 is of importance in follow-up detecting ovarian cancer.This study aimed to comprehensively evaluate values of CA125 based on chemiluminescence-enzyme immunoassay in diagnosing recurrent and metastatic of ovarian cancer.METHODS Studies about recurrent and metastatic of ovarian cancer diagnosed by CA125 until January 2018 were searched in the databases such as PubMed,Embase,Cochrane,Web of Science,CNKI,CBM,VIP and Wanfang.Two reviewers independently screened literature and extracted data strictly according to included and excluded criterion,and assessed bias risk by QUADAS-2 gulidline.Meta analysis was performed by Stata 12.0 software.The pooled weighted Sentivity(Sen),Specificity(Spe),Positive Likelihood Ratio(PLR),Negative Likelihood Ratio(NLR)and Diagnostic odds ratio(DOR)were calculated,receiver operating characteristic(ROC)and area under ROC curve(AUC)were also drawn.RESULTS A total of 24 diagnostic studies and 1 717 patients were included.Results of this meta analysis showed pooled Sen,Spe,PLR,NLR,DOR and AUC of CA125 diagnosing recurrent and metastatic of ovarian cancer were0.72(95%CI:0.65-0.79),0.90(95%CI:0.83-0.94),7.26(95%CI:4.13-12.20),0.31(95%CI:0.24-0.39),23.51(95%CI:12.71-43.48)and 0.87(95%CI:0.84-0.90),respectively.Subgroup results showed CA125 had better diagnostic value in patients with age≥53 years compared to age<53 years:(AUC=0.88(95%CI:0.85-0.91)vs AUC=0.72(95%CI:0.68-0.76),P=0.002.CONCLUSION CA125 has higher diagnostic efficiency and differential diagnosis for assessing recurrent and metastatic of ovarian cancer,especially in patients age≥53 years.更多还原