摘要
目的系统评价血管内皮生长因子(VEGF)在恶性腹腔积液鉴别诊断中的价值。方法计算机检索MEDLINE、EMbase、Cochrane Library、OVID循证医学数据库及中国期刊网、维普、万方等数据库,查找有关VEGF在恶性腹腔积液鉴别诊断价值的文献,检索时间从1990年1月至2009年12月。采用QUADAS工具评价纳入文献质量,应用Meta-Disc 1.4软件对纳入研究进行综合定量评价,并绘制SROC曲线,对诊断性试验的准确性进行评估。结果共纳入7篇文献。血管内皮生长因子对恶性腹腔积液的鉴别诊断价值分别为:合并敏感度81%[95%CI(0.75,0.85)],合并特异度90%[95%CI(0.86,0.94)],DOR 50.45[95%CI(28.37,89.73)],SROC曲线下面积(AUC)0.9507(SE=0.0130),Q=0.8914(SE=0.0176)。本研究还对人种、试剂来源进行了亚组分析,其中VEGF试剂盒购自R&D公司的3个研究(χ2=0.05,P=0.9750;I2=0.0%)同质性较好,AUC=0.9675(SE=0.0167)。结论经SROC曲线证实,血管内皮生长因子在恶性腹腔积液鉴别诊断中具有较高的敏感度和特异度,可作为重要的筛查和诊断指标。
Objective To establish the overall diagnostic accuracy of the measurements of vascular endothelial growth factor（VEGF） for malignant ascites.Methods After a systematic review of current studies,sensitivity,specificity,and other measures of the value of ascites concentrations of VEGF in the diagnosis of malignant ascites were pooled by using random effects models.Qualified studies on evaluation of VEGF in diagnosis of malignant ascites in English and Chinese published from January 1990 to December 2009 were retrieved from The Cochrane Library,Cochrane Central Register of Controlled Trials,MEDLINE,EMbase,China National Knowledge Infrastructure（CNKI） databases,WanFang Data,and VIP Information.Two reviewers independently assessed the methodological quality of each study with the tool of QUADAS.Statistical analyses were performed by employing Meta-Disc 1.4 software.Meta-analyses of the reported sensitivity and specificity of each study and Summary Receiver Operating Characteristic（SROC） curve were performed.Results Seven studies met the inclusion criteria for the analysis.After testing the heterogeneity of the included studies,a random effect model was selected to calculate the pool weighted sensitivity and specificity with 95% confidence interval： the sensitivity was 0.81（95%CI 0.75 to 0.85）,the specificity was 0.90（95%CI 0.86 to 0.94）,the DOR was 50.45（95%CI 28.37 to 89.73）,and the AUC of SROC was 0.9507（SE=0.0130）.The subgroups were analyzed to identify the sources of heterogeneity according to race and agent sources.There was homogeneity among the three studies with agents from RD company（χ2=0.05,P=0.9750;I2=0.0%）,and the AUC of SROC were 0.9675（SE=0.0167）.Conclusion VEGF has a highly accurate sensitivity and specificity with a strong ROC curve,which makes it a new marker to differentiate malignant ascites from the benign.
出处
《中国循证医学杂志》
CSCD
2011年第2期220-225,共6页
Chinese Journal of Evidence-based Medicine
关键词
血管内皮生长因子
恶性腹腔积液
鉴别诊断
META分析
Vascular endothelial growth factor
Malignant ascites
Differential diagnosis
Meta analysis
