摘要
背景与目的:前列腺特异性抗原(prostate-specific antigen,PSA)是一种前列腺癌标志物,但关于使用PSA作为筛查标准是否合适仍存在争论。评价PSA在中国人群前列腺癌早期检测中的价值,旨在为前列腺癌筛查策略的制定提供依据。方法:对万方数据库、中国医院知识仓库(China Hospital Knowledge Database,CHKD)和PubMed数据库进行文献检索,再根据已发表文献中的参考文献追溯进行手工检索。收集2000年1月—2020年3月有关PSA对中国人群前列腺癌早期检测的文献资料。按确定的纳入标准筛选文献,对纳入的文献进行质量评价。对以PSA>4 ng/mL作为临界点检测前列腺癌的灵敏度、特异度等进行Meta分析。结果:共检索到5722篇文献,排除重复及不符合标准的5713篇后,纳入9篇文献。累计研究对象共6425人,其中前列腺癌患者596例;Meta分析结果显示,以PSA>4 ng/mL作为临界点检测前列腺癌的灵敏度、特异度和集成受试者工作特征(summary receiver operating characteristic,SROC)曲线的曲线下面积(area under curve,AUC)分别为91%(95%CI:89%~93%)、41%(95%CI:27%~56%)和0.91(95%CI:0.88~0.93)。结论:中国人群中以PSA>4 ng/mL作为检测前列腺癌的界值,具有较高的灵敏度,但特异度较低,前列腺癌筛查可在PSA>4 ng/mL的基础上进一步筛选。
Background and purpose:Prostate-specific antigen(PSA)is a tumor marker for prostate cancer screening and detection.However,there is still some debate over whether it is appropriate to use PSA>4 ng/mL as a screening standard.The purpose of this study was to evaluate the value of PSA in the early detection of prostate cancer in Chinese,and to provide basis for the development of prostate cancer screening strategy.Methods:By searching the literature stored in Wanfang database,China Hospital Knowledge Database(CHKD)and PubMed database,and tracing the literature,we collected the relevant literature about PSA in the early diagnosis of prostate cancer in Chinese population from Jan.2000 to Mar.2002.According to the established inclusion criteria,the literature was screened,and the quality of the literature was evaluated.The sensitivity and specificity of PSA>4 ng/mL as the critical point for the detection of prostate cancer were analyzed by Meta-analysis.Results:A total of 5722 articles were retrieved,and 9 articles were included after 5713 articles were excluded.The total number of subjects was 6425,including 596 cases of prostate cancer.The results of meta-analysis showed that the sensitivity,specificity and area under curve(AUC)of summary receiver operating characteristics(SROC)curves of PSA were 91%(95%CI:89%-93%),41%(95%CI:27%-56%)and 0.91(95%CI:0.88-0.93),respectively.Conclusion:In Chinese population,PSA>4 ng/mL as the threshold of prostate cancer detection,has high sensitivity,but low specificity.Prostate cancer screening could be based on PSA>4 ng/mL.
作者
王宝华
沙宇婷
何凤蝶
吴静
WANG Baohua;SHA Yuting;HE Fengdie;WU Jing(The National Center for Chronic and Noncommunicable Disease Control and Prevention,Beijing 100050,China)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2020年第11期879-886,共8页
China Oncology
基金
国家重点研发计划项目(2016YFC1302603,2016YFC1302600)。
