可溶性肿瘤抑制因子2对心力衰竭的诊断价值
Diagnostic Value of Soluble Suppression of Tumorigenicity-2 for Heart Failure.
作者信息
Huang Dong-Hui, Sun Hao, Shi Jing-Pu
机构信息
Department of Clinical Epidemiology and Evidence-based Medicine, Institute of Cardiovascular Diseases, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China.
出版信息
Chin Med J (Engl). 2016 Mar 5;129(5):570-7. doi: 10.4103/0366-6999.177000.
BACKGROUND
Many studies have explored the diagnostic performance of soluble suppression of tumorigenicity-2 (sST2) for heart failure (HF), but the results are inconsistent. Here, we performed a meta-analysis to assess the role of sST2 in the diagnosis of HF.
METHODS
We searched PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database from inception to April 2015. Studies that investigated the diagnostic role of sST2 for HF were reviewed. The numbers of true-positive, false-positive, false-negative, and true-negative results were extracted to calculate pooled diagnostic odds ratio (DOR) with 95% confidence interval (CI) and the summary receiver operating characteristic curve and area under the curve (AUC). The Spearman correlation coefficient was used to check the threshold effect. The Cochran Q statistic (P < 0.05) and the inconsistency index (I2 > 50%) were used to assess the nonthreshold effect. Meta-regression was conducted to explore the source of heterogeneity; subgroup analysis showed the results in different subgroups. Finally, the Deeks' test was performed to assess the publication bias.
RESULTS
Nine articles including 10 studies were included in the meta-analysis. The pooled sensitivity was 0.84 (95% CI: 0.81-0.86), and pooled specificity was 0.74 (95% CI: 0.72-0.76). The summary DOR was 8.49 (95% CI: 4.54-15.86), and AUC was 0.81 (standard error: 0.03). The Spearman correlation coefficient identified the nonsignificant threshold effect (coefficient = 0.49, P = 0.148), but the nonthreshold effect heterogeneity was significant (Cochran Q = 58.52, P < 0.0001; I2 = 84.6%). Meta-regression found that characteristics of controls might be the suggestive source of nonthreshold effect heterogeneity (P = 0.095). Subgroup analysis found that DOR was 5.65 and 7.86, respectively for the controls of hospital patients and healthy populations. Deeks' test demonstrated that there was no publication bias (P = 0.616).
CONCLUSION
The meta-analysis illustrated that sST2 might play a role in diagnosing HF.
背景
许多研究探讨了可溶性肿瘤生长抑制因子2（sST2）对心力衰竭（HF）的诊断效能，但结果并不一致。在此，我们进行了一项荟萃分析，以评估sST2在HF诊断中的作用。
方法
我们检索了从创刊至2015年4月的PubMed、Web of Science、Cochrane图书馆、中国知网和万方数据库。对研究sST2对HF诊断作用的研究进行了综述。提取真阳性、假阳性、假阴性和真阴性结果的数量，以计算合并诊断比值比（DOR）及其95%置信区间（CI），以及汇总受试者工作特征曲线和曲线下面积（AUC）。采用Spearman相关系数检验阈值效应。采用Cochran Q统计量（P<0.05）和不一致指数（I2>50%）评估非阈值效应。进行Meta回归以探索异质性来源；亚组分析展示了不同亚组的结果。最后，进行Deeks检验以评估发表偏倚。
结果
荟萃分析纳入了9篇文章，共10项研究。合并灵敏度为0.84（95%CI：0.81-0.86），合并特异度为0.74（95%CI：0.72-0.76）。汇总DOR为8.49（95%CI：4.54-15.86），AUC为0.81（标准误：0.03）。Spearman相关系数显示阈值效应不显著（系数=0.49，P=0.148），但非阈值效应异质性显著（Cochran Q=58.52，P<0.0001；I2=84.6%）。Meta回归发现对照特征可能是非阈值效应异质性的潜在来源（P=0.095）。亚组分析发现，医院患者对照和健康人群对照的DOR分别为5.65和7.86。Deeks检验表明不存在发表偏倚（P=0.616）。
结论
荟萃分析表明，sST2可能在HF诊断中发挥作用。
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