Ji Baoyan, Cheng Xiongfei, Cai Xiaojun, Kong Chuiyan, Yang Qingyan, Fu Ting, Wang Yahang, Song Ying
Department of Oncology, Qinghai Province People's Hospital, Xining Qinghai81000, China.
Department of Oncology Center, The People's Hospital of Shiyan City HubeiProvince442000China.
Open Med (Wars). 2017 Oct 11;12:347-353. doi: 10.1515/med-2017-0050. eCollection 2017.
The aim of this study was to evaluate the diagnostic value of serumCK20 mRNA as a biomarker for colorectal cancer diagnosis by meta-analysis. Clinical studies related to serum CK20 mRNA expression for colorectal cancer diagnosis were searched in the databases of Pubmed, Cochrane Library, Embase, ISI Web of Knowledge, CNKI and Wanfang. The number of true positive (tp), false positive (fp), false negative (fn) and true negative (tn) of the original included publications were extracted by two reviewers independently. The diagnostic sensitivity, specificity, positive likely hood ratio (+LR), negative likelyhood ratio (-LR), diagnostic odds ratio (DOR) and area under the symmetric ROC curve (AUC) were pooled by random or fixed effect method according to the statistical heterogeneity among the studies. After screening the databases, nineteen publications met the inclusion criteria and were finally included in this meta-analysis. The diagnostic sensitivity and specificity were pooled by random effect model(I2>50%). The pooled diagnostic sensitivity and specificity of CK20 mRNA in serum as biomarker for colorectal cancer were 0.49 (95% CI:0.46 to 0.51) and 0.94 (95%CI:0.92-0.96) respectively. The pooled +LR and -LR were 10.90 (95%CI:5.78 to 20.55) and 0.51 (95%CI:0.45 to 0.57) respectively by random-effect method. The pooled DOR was 22.31 with the 95% CI of 11.65 to 42.71. The pooled area under the ROC curve (AUC) was 0.72for CK20 mRNA in serum as a biomarker for colorectal cancer diagnosis. Conclusion Serum CK20 mRNA expression was significantly elevated in colorectal cancer patients which could be a promising serum biomarker for colorectal cancer diagnosis with high specificity.
本研究旨在通过荟萃分析评估血清CK20 mRNA作为生物标志物在结直肠癌诊断中的诊断价值。在PubMed、Cochrane图书馆、Embase、ISI Web of Knowledge、中国知网和万方数据库中检索与血清CK20 mRNA表达用于结直肠癌诊断相关的临床研究。由两名审阅者独立提取原始纳入出版物的真阳性(tp)、假阳性(fp)、假阴性(fn)和真阴性(tn)数量。根据研究间的统计异质性,采用随机或固定效应方法汇总诊断敏感性、特异性、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR)和对称ROC曲线下面积(AUC)。在筛选数据库后,19篇出版物符合纳入标准,最终纳入本荟萃分析。诊断敏感性和特异性采用随机效应模型合并(I2>50%)。血清中CK20 mRNA作为结直肠癌生物标志物的合并诊断敏感性和特异性分别为0.49(95%CI:0.46至0.51)和0.94(95%CI:0.92 - 0.96)。采用随机效应方法,合并的+LR和-LR分别为10.90(95%CI:5.78至20.55)和0.51(95%CI:0.45至0.57)。合并的DOR为22.31,95%CI为11.65至42.71。血清中CK20 mRNA作为结直肠癌诊断生物标志物的合并ROC曲线下面积(AUC)为0.72。结论:结直肠癌患者血清CK20 mRNA表达显著升高,可能是一种有前景的、具有高特异性的结直肠癌诊断血清生物标志物。