Wang Weilin, Zhang Lufei, Chen Linghui, Wei Jianfeng, Sun Qiang, Xie Qingshong, Zhou Xiaohu, Zhou Dongkai, Huang Pengfei, Yang Qifan, Xie Haiyang, Zhou Lin, Zheng Shusen
Key Laboratories of Combined Multi-Organ Transplantation, Ministry of Public Health, and The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China ; Key Laboratories of Organ Transplantation, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
Key Laboratories of Combined Multi-Organ Transplantation, Ministry of Public Health, and The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
Biomed Rep. 2015 Jan;3(1):43-50. doi: 10.3892/br.2014.376. Epub 2014 Nov 3.
The clinical importance of intraductal papillary mucinous neoplasms (IPMN) of the pancreas has been increasing due to the large number of newly diagnosed cases. A meta-analysis was used to assess the accuracy of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) for the identification of malignant and invasive IPMN. A literature search of PubMed and Web of Knowledge was conducted. Studies included in the analysis addressed the diagnostic accuracy of serum CEA and CA19-9 and pooled estimates of sensitivity, specificity, positive- and negative-likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR) and receiver operating characteristic curves were calculated using random-effects models. Predefined subgroup analysis was performed. Fifteen studies (published between 2001 and 2013) were analyzed, including a total of 1,629 patients. Pooled estimates of CEA in malignant and invasive IPNM prediction were: Pooled sensitivity, 18 and 18%; pooled specificity, 93 and 95%; PLR, 2.83 and 3.54; NLR, 0.89 and 0.89; and DOR, 3.35 and 3.6, respectively. Pooled estimates of CA19-9 in malignant and invasive IPMN prediction were: Pooled sensitivity, 40 and 52%; pooled specificity, 89 and 88%; PLR, 2.93 and 3.78; NLR, 0.74 and 0.6; and DOR, 4.34 and 6.33, respectively. In conclusion, serum CEA has low sensitivity and high specificity for malignant and invasive IPMN. Serum CA19-9 is a useful non-invasive preoperative tool for differentiating between invasive and benign IPMN and should be taken into account in the decision to perform surgery.
由于新诊断病例数量众多，胰腺导管内乳头状黏液性肿瘤（IPMN）的临床重要性日益增加。一项荟萃分析用于评估血清癌胚抗原（CEA）和糖类抗原19-9（CA19-9）对恶性和侵袭性IPMN的识别准确性。对PubMed和Web of Knowledge进行了文献检索。纳入分析的研究涉及血清CEA和CA19-9的诊断准确性，并使用随机效应模型计算敏感性、特异性、阳性和阴性似然比（PLR和NLR）、诊断比值比（DOR）以及受试者工作特征曲线的合并估计值。进行了预定义的亚组分析。分析了15项研究（发表于2001年至2013年之间），共纳入1629例患者。CEA在恶性和侵袭性IPNM预测中的合并估计值分别为：合并敏感性18%和18%；合并特异性93%和95%；PLR 2.83和3.54；NLR 0.89和0.89；DOR 3.35和3.6。CA19-9在恶性和侵袭性IPMN预测中的合并估计值分别为：合并敏感性40%和52%；合并特异性89%和88%；PLR 2.93和3.78；NLR 0.74和0.6；DOR 4.34和6.33。总之，血清CEA对恶性和侵袭性IPMN的敏感性低、特异性高。血清CA19-9是区分侵袭性和良性IPMN的有用非侵入性术前工具，在决定是否进行手术时应予以考虑。
