摘要
目的通过Meta分析探讨检测非小细胞肺癌患者外周血EGFR基因突变的临床价值。方法2位研究者按照相同的检索策略分别进行独立检索,根据纳入标准与排除标准进一步筛选。确定纳入文献后使用Meta-DiSc 1.4和RevMan 5.1软件进行分析,分析指标包括敏感度、特异度、诊断优势比(DOR)。结果筛选后共纳入13项研究,包括1 105例研究样本。Meta分析结果显示,汇总后的敏感度为66%(95%CI=0.61~0.71,I2=81.6%);特异度为96%(95%CI=0.94~0.97,I2=61.9%),Spearman相关系数为-0.022,P=0.943,不存在阈值效应;DOR为54.78(95%CI=28.11~106.75,I2=31.2%)。SROC曲线分析AUC=0.963 1,Q*=0.909 1。结论外周血代替组织进行EGFR基因突变检测的特异度高而敏感度低。外周血尚无法完全替代肿瘤组织进行EGFR基因突变检测,但可以成为组织检测的有效补充。但当外周血检测提示EGFR基因突变阴性时,应充分考虑到可能产生的漏诊。
Objective Analysis of the peripheral blood testing by meta-analysis to evaluate the application of EGFR gene mutation in patients with non-small cell lung cancer by meta-analysis. MethodsData were collected from different databases by two independent researchers following predetermined inclusion and exclusion criteria. Meta-analysis of the sensitivity,the specificity,and the diagnostic odds ratio(DOR)was performed using Meta-DiSc 1.4and RevMan 5.1software. Results 13 studies were included after the screening. The included studies consisted of 1 105 cases of the study sample. Analysis results showed that the pooled sensitivity and specificity were 66%(95%CI=0.61~0.71,I2=81.6%)and96%(95%CI=0.94~0.97,I2=61.9%)respectively. Spearman correlation coefficient-0.022,P=0.943. There was no threshold effect. The DOR was 54.78(95%CI=28.11~106.75,I2=31.2%). Analysis of the SROC:AUC=0.9631,Q*=0.9091. Conclusion Peripheral blood samples was with high specificity but a slightlylow sensitivity for detecting EGFR mutations compared to tumor tissues. The results of this meta-analysis suggest that peripheral blood is insufficient as a substitute for tumor tissues in detecting EGFR mutations.
出处
《福建医科大学学报》
北大核心
2015年第3期158-162,共5页
Journal of Fujian Medical University
基金
海南省医学科研重点课题(琼卫2012 2D-02)
