Wang Siliang, Chen Xiaodong, Tang Meiyue
Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, 110022, China,
Tumour Biol. 2014 Aug;35(8):7897-904. doi: 10.1007/s13277-014-2053-3. Epub 2014 May 15.
Many studies have shown that human telomerase activity could play potential role as a diagnostic biomarker of pancreatic cancer (PaC). The aim of this meta-analysis is to summarize the clinical value of human telomerase activity in the diagnosis of PaC. Eligible studies from PubMed, Embase, the Cochrane Library, Web of Science, Ovid, Sci Verse, Science Direct, Scopus, BioMed Central, Biosis previews, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Technology of Chongqing (VIP), and Wan Fang databases were searched concerning the diagnostic value of human telomerase activity in PaC without language restriction. The quality of each study was scored with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), and diagnostic odds ratio (DOR) for human telomerase activity in the diagnosis of PaC were pooled. Summary receiver operating characteristic (SROC) curve analysis and the area under the curve (AUC) were used to estimate the overall test performance. Evidence of heterogeneity was evaluated using the Chi-square and I (2) test. Meta-Disc 1.4 and Stata 12.0 software were used to analyze the data. Nine studies with a total 186 PaC patients and 132 control individuals were included in this meta-analysis. All of the included studies are of high quality (QUADAS score ≥10). The summary estimate was 0.83 (95 % confidence interval (CI), 95 % CI = 0.77-0.88) for sensitivity and 0.72 (95 % CI = 0.64-0.79) for specificity. The positive likelihood (PLR), negative likelihood (NLR), and diagnostic odds (DOR) ratios were 3 (95 % CI = 1.67-5.41), 0.25 (95 % CI = 0.13-0.46), and 3 (95 % CI = 4.91-43.23), respectively. The area under the summary ROC curve (AUC) and Q* index for the diagnosis of PaC were 0.88 and 0.81, respectively. Our study demonstrates that telomerase could be a useful tumor marker for PaC diagnosis. Although more studies are needed to highlight the theoretical strengths, these results will provide theoretical basis for bringing telomerase activity detection into PaC screening plan.
许多研究表明，人端粒酶活性可能作为胰腺癌（PaC）的一种诊断生物标志物发挥潜在作用。本荟萃分析的目的是总结人端粒酶活性在PaC诊断中的临床价值。通过检索PubMed、Embase、Cochrane图书馆、Web of Science、Ovid、Sci Verse、Science Direct、Scopus、BioMed Central、Biosis previews、中国生物医学文献数据库（CBM）、中国知网（CNKI）、重庆维普（VIP）和万方数据库，纳入有关人端粒酶活性在PaC诊断中价值的符合条件的研究，无语言限制。采用诊断准确性研究质量评估（QUADAS）对每项研究的质量进行评分。汇总人端粒酶活性在PaC诊断中的敏感性、特异性、阳性和阴性似然比（分别为PLR和NLR）以及诊断比值比（DOR）。采用汇总受试者工作特征（SROC）曲线分析和曲线下面积（AUC）来估计总体检验性能。使用卡方检验和I²检验评估异质性证据。采用Meta-Disc 1.4和Stata 12.0软件进行数据分析。本荟萃分析纳入了9项研究，共186例PaC患者和132例对照个体。所有纳入研究均为高质量（QUADAS评分≥10）。敏感性的汇总估计值为0.83（95%置信区间（CI），95%CI = 0.77 - 0.88），特异性为0.72（95%CI = 0.64 - 0.79）。阳性似然比（PLR）、阴性似然比（NLR）和诊断比值比（DOR）分别为3（95%CI = 1.67 - 5.41）、0.25（95%CI = 0.13 - 0.46）和3（95%CI = 4.91 - 43.23）。诊断PaC的汇总ROC曲线下面积（AUC）和Q*指数分别为0.88和0.81。我们的研究表明，端粒酶可能是PaC诊断的一种有用肿瘤标志物。尽管需要更多研究来突出理论优势，但这些结果将为将端粒酶活性检测纳入PaC筛查计划提供理论依据。
