Yang Jing, Li Sainan, Li Jingjing, Wang Fan, Chen Kan, Zheng Yuanyuan, Wang Jianrong, Lu Wenxia, Zhou Yuqing, Yin Qin, Zhang Huawei, Guo Chuanyong
Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China; The First Clinical Medical College of Nanjing Medical University, Nanjing 210029, China.
Pancreatology. 2016 Jul-Aug;16(4):605-14. doi: 10.1016/j.pan.2016.04.033. Epub 2016 May 12.
K-ras codon 12 mutation is one of the earliest genetic changes in the development of pancreatic cancer (PC) and accurate detection of K-ras mutations is gaining increasing attention in the field of molecular diagnosis.
Original research articles which evaluated the diagnostic accuracy of K-ras mutation detection in PC were selected. Data were presented as forest plots and summary receiver operating characteristic curve analysis was used to summarize the overall test performance.
We assessed 16 studies from 15 published articles. The pooled sensitivity and specificity were 59% (95%CI: 54%-64%) and 87% (95%CI: 84%-89%), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 4.13 (95%CI: 2.73-6.25) and 0.42 (95%CI: 0.32-0.56), respectively, and the pooled diagnostic odds ratio was 13.66 (95% CI: 7.25-25.74).
Our results indicate that the analysis of K-ras mutations in pancreatic juice has a considerable diagnostic value in PC. Further studies with rigorous design, large sample size, and multi-regional co-operation are needed.
K-ras密码子12突变是胰腺癌（PC）发生过程中最早出现的基因变化之一，K-ras突变的准确检测在分子诊断领域日益受到关注。
选择评估PC中K-ras突变检测诊断准确性的原始研究文章。数据以森林图呈现，并采用汇总受试者工作特征曲线分析来总结总体检测性能。
我们评估了15篇已发表文章中的16项研究。汇总敏感性和特异性分别为59%（95%CI：54%-64%）和87%（95%CI：84%-89%）。汇总阳性似然比和阴性似然比分别为4.13（95%CI：2.73-6.25）和0.42（95%CI：0.32-0.56），汇总诊断比值比为13.66（95%CI：7.25-25.74）。
我们的结果表明，胰液中K-ras突变分析在PC中具有相当大的诊断价值。需要进行设计严谨、样本量大且多地区合作的进一步研究。
