Zhen Shuai, Bian Li-Hong, Chang Li-Li, Gao Xin
Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China ; Department of Pharmacology and Toxicology, Beijing Institute of Radiation Medicine, Beijing 100850, P.R. China.
Department of Gynecology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100850, P.R. China.
Mol Clin Oncol. 2014 Jul;2(4):559-566. doi: 10.3892/mco.2014.279. Epub 2014 Apr 16.
Ovarian cancer (OC) is the third most common type of gynecological cancer. Measurements of human epididymis protein 4 (HE4) levels have been suggested for improving the specificity of the laboratory identification of OC. For this meta-analysis, the Medline, Embase and Cochrane databases were searched to identify relevant studies. All the included studies for diagnostic performance were combined with sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratios (DORs) with 95% confidence intervals (CIs), summary receiver operating characteristic (SROC) curves and areas under the SROC curves (AUC). A total of 25 studies including 4,729 patients were identified as eligible for inclusion in the final analysis. The pooled sensitivities and respective 95% CIs for HE4 and carbohydrate antigen 125 (CA125) were 0.74 (0.72-0.76) and 0.74 (0.72-0.76), respectively. The pooled specificities and respective 95% CIs for HE4 and CA125 were 0.90 (0.89-0.91) and 0.83 (0.81-0.84), respectively. The summary DORs and 95% CIs for HE4 and CA125 were 43.35 (29.13-64.51) and 17.06 (10.97-26.51), respectively and the AUCs for HE4 and CA125 were 0.8915 and 0.8538, respectively. In total, 9 studies investigated the diagnostic accuracy of HE4 combined with CA125 for the diagnosis of OC. The pooled sensitivity and 95% CIs of HE4, CA125 and HE4+CA125 in this subgroup were 0.71 (0.67-0.75), 0.74 (0.69-0.78) and 0.90 (0.87-0.92), respectively; the pooled specificity and 95% CIs of HE4, CA125 and HE4+CA125 were 0.92 (0.90-0.94), 0.73 (0.69-0.76) and 0.85 (0.82-0.87), respectively. The diagnostic accuracy of HE4 in distinguishing OC from other benign gynecological diseases was found to be to be superior to that of CA125 and the combination of HE4 and CA125 may enhance the diagnostic sensitivity.
卵巢癌（OC）是第三常见的妇科癌症类型。有人建议检测人附睾蛋白4（HE4）水平以提高卵巢癌实验室诊断的特异性。为进行这项荟萃分析，检索了Medline、Embase和Cochrane数据库以识别相关研究。所有纳入的诊断性能研究均合并了敏感性、特异性、阳性似然比、阴性似然比、诊断比值比（DOR）及其95%置信区间（CI）、汇总受试者工作特征（SROC）曲线以及SROC曲线下面积（AUC）。共确定25项研究（包括4729例患者）符合纳入最终分析的条件。HE4和糖类抗原125（CA125）的合并敏感性及其各自的95%CI分别为0.74（0.72 - 0.76）和0.74（0.72 - 0.76）。HE4和CA125的合并特异性及其各自的95%CI分别为0.90（0.89 - 0.91）和0.83（0.81 - 0.84）。HE4和CA125的汇总DOR及其95%CI分别为43.35（29.13 - 64.51）和17.06（10.97 - 26.51），HE4和CA125的AUC分别为0.8915和0.8538。总共9项研究调查了HE4联合CA125对卵巢癌的诊断准确性。该亚组中HE4、CA125和HE4 + CA125的合并敏感性及其95%CI分别为0.71（0.67 - 0.75）、0.74（0.69 - 0.78）和0.90（0.87 - 0.92）；HE4、CA125和HE4 + CA125的合并特异性及其95%CI分别为0.92（0.90 - 0.94）、0.73（0.69 - 0.76）和0.85（0.82 - 0.87）。发现HE4在区分卵巢癌与其他良性妇科疾病方面的诊断准确性优于CA125，且HE4与CA125联合使用可能会提高诊断敏感性。
