Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, China.
Department Radiology, The 2nd Hospital Affiliated to Jilin University, Changchun, China.
World J Urol. 2018 Sep;36(9):1373-1381. doi: 10.1007/s00345-018-2285-8. Epub 2018 Apr 2.
This study is a meta-analysis and aims to determine the value of urinary survivin for detecting bladder cancer (BC) on the basis of preceding statistical performance and to compare their diagnostic value.
Considering that the urinary survivin data were from both RNA and protein levels, the key words "bladder cancer" AND "survivin" and "bladder cancer" AND "survivin RNA" were used; and PubMed, Web of Science, and Cochrane Library were systematically searched to identify relevant articles. The methodological quality of each study was assessed by QUADAS-2. Data were analyzed by STATA 12.0 and Meta-disc v.1.4 software package. A random-effects model was used and subgroup analysis was carried out to identify possible sources of heterogeneity.
Nine articles for survivin protein test with 789 patients and 684 controls, and 12 articles for survivin RNA test with 880 patients and 922 controls were identified. The results showed that the pooled sensitivity was 0.79 (95% CI 0.73, 0.84), specificity was 0.87 (95% CI 0.79, 0.92) of the survivin protein test for bladder cancer, and the sensitivity and specificity was 0.84 (95% CI 0.79, 0.88) and 0.94 (95% CI 0.89, 0.97) of the survivin RNA test. The AUC of the two approaches was 0.89 (95% CI 0.86, 0.91) and 0.94 (95% CI 0.92, 0.96), respectively.
The survivin protein and survivin RNA both had great potential as biomarkers for BC detection, and survivin RNA showed higher accuracy than survivin protein on BC diagnosis.
本研究通过荟萃分析旨在根据前期统计性能确定尿生存素检测膀胱癌（BC）的价值，并比较其诊断价值。
考虑到尿生存素数据来自 RNA 和蛋白质水平，使用了“膀胱癌”和“生存素”以及“膀胱癌”和“生存素 RNA”的关键词；并通过 PubMed、Web of Science 和 Cochrane Library 系统地搜索了相关文章。使用 QUADAS-2 评估每项研究的方法学质量。使用 STATA 12.0 和 Meta-disc v.1.4 软件包分析数据。使用随机效应模型进行分析，并进行亚组分析以确定可能存在的异质性来源。
共确定了 9 篇关于生存素蛋白检测的文章，共 789 例患者和 684 例对照，12 篇关于生存素 RNA 检测的文章，共 880 例患者和 922 例对照。结果显示，生存素蛋白检测膀胱癌的合并敏感性为 0.79（95%CI 0.73，0.84），特异性为 0.87（95%CI 0.79，0.92），生存素 RNA 检测的敏感性和特异性分别为 0.84（95%CI 0.79，0.88）和 0.94（95%CI 0.89，0.97）。两种方法的 AUC 分别为 0.89（95%CI 0.86，0.91）和 0.94（95%CI 0.92，0.96）。
生存素蛋白和生存素 RNA 均有作为 BC 检测生物标志物的巨大潜力，且生存素 RNA 在 BC 诊断中比生存素蛋白具有更高的准确性。
