Wisteria floribunda agglutinin-sialylated mucin1 诊断价值的荟萃分析及其在人胆管癌中的预后作用

Meta-analysis of the diagnostic value of Wisteria floribunda agglutinin-sialylated mucin1 and the prognostic role of mucin1 in human cholangiocarcinoma.

机构信息

The First Clinical Medical School of Lanzhou University, Lanzhou, China.

Department of General Surgery, West China Hospital/West China Medical School, Sichuan University, Chengdu, China.

出版信息

BMJ Open. 2019 Jan 29;9(1):e021693. doi: 10.1136/bmjopen-2018-021693.

DOI:10.1136/bmjopen-2018-021693

PMID:30700476

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6352767/

Abstract

OBJECTIVE

Serum carbohydrate antigen 19-9 (CA19-9) is a widely used tumour marker for cholangiocarcinoma (CCA). However, it is not a necessarily good CCA marker in terms of diagnostic accuracy. The purpose of this study is to evaluate the diagnostic value of agglutinin-sialylated Mucin1 (WFA-MUC1) and the prognostic role of Mucin1 (MUC1) in human CCA.

DESIGN

Meta-analysis.

DATA SOURCES

Studies published in PubMed, Web of Science, The Cochrane Library and the China National Knowledge Infrastructure up to 11 October 2017.

ELIGIBILITY CRITERIA

We included reports assessing the diagnostic capacity of WFA-MUC1 and the prognostic role of MUC1 in CCA. The receiver operating characteristic curve (ROC) of WFA-MUC1 and/or CA19-9 was described, and the HRs including 95% CI and the corresponding p value for MUC1 can be extracted.

DATA EXTRACTION AND SYNTHESIS

Two independent researchers extracted data and assessed risk of bias. The diagnostic sensitivity and specificity data of WFA-MUC1 were extracted and analysed as bivariate data. Pooled HRs and its 95% CI for MUC1 were calculated with a random-effects meta-analysis model on overall survival of resectable CCA.

RESULTS

Sixteen reports were included in this study. The pooled sensitivity and specificity of WFA-MUC1 were 0.76 (95% CI 0.71 to 0.81) and 0.72 (95% CI 0.59 to 0.83) in serum, 0.85 (95% CI 0.81 to 0.89) and 0.72 (95% CI 0.64 to 0.80) in bile and 0.72 (95% CI 0.50 to 0.87) and 0.85 (95% CI 0.70 to 0.93) in tissue, respectively. The summary ROC (SROC) were 0.77 (95% CI 0.73 to 0.81) in serum, 0.88 (95% CI 0.85 to 0.90) in bile and 0.86 (95% CI 0.83 to 0.89) in tissue, respectively. Furthermore, the pooled sensitivity and specificity and the SROC of CA19-9 in serum were 0.67 (95% CI 0.61 to 0.72), 0.86 (95% CI 0.75 to 0.93) and 0.75 (95% CI 0.71 to 0.79), respectively. The pooled HRs for MUC1 was 2.20 (95% CI 1.57 to 3.01) in CCA and 4.17 (95% CI 1.71 to 10.17) in mass-forming intrahepatic CCA.

CONCLUSIONS

Compared with CA19-9, WFA-MUC1 was shown to possess stronger diagnostic capability. MUC1 could serve as a prognosis factor for poor outcomes of CCA, particularly, mass-forming intrahepatic CCA.

摘要

目的

血清碳水化合物抗原 19-9（CA19-9）是胆管癌（CCA）广泛使用的肿瘤标志物。然而，就诊断准确性而言，它不一定是一个很好的 CCA 标志物。本研究旨在评估凝集素唾液酸化粘蛋白 1（WFA-MUC1）的诊断价值和 Mucin1（MUC1）在人类 CCA 中的预后作用。

设计

荟萃分析。

资料来源

截至 2017 年 10 月 11 日，在 PubMed、Web of Science、The Cochrane Library 和中国国家知识基础设施中发表的研究。

入选标准

我们纳入了评估 WFA-MUC1 诊断能力和 MUC1 在 CCA 中的预后作用的报告。描述了 WFA-MUC1 和/或 CA19-9 的受试者工作特征曲线（ROC），可以提取包括 95%置信区间和相应 p 值的 MUC1 的 HR。

资料提取和综合

两名独立研究人员提取数据并评估偏倚风险。提取 WFA-MUC1 的诊断敏感性和特异性数据，并作为双变量数据进行分析。使用随机效应荟萃分析模型计算可切除 CCA 总生存率的 MUC1 的汇总 HR 和其 95%置信区间。

结果

本研究纳入了 16 份报告。WFA-MUC1 的血清、胆汁和组织中的汇总敏感性和特异性分别为 0.76（95%置信区间 0.71 至 0.81）和 0.72（95%置信区间 0.59 至 0.83）、0.85（95%置信区间 0.81 至 0.89）和 0.72（95%置信区间 0.64 至 0.87）、0.72（95%置信区间 0.50 至 0.87）和 0.85（95%置信区间 0.70 至 0.93）。血清、胆汁和组织的汇总 ROC（SROC）分别为 0.77（95%置信区间 0.73 至 0.81）、0.88（95%置信区间 0.85 至 0.90）和 0.86（95%置信区间 0.83 至 0.89）。此外，血清 CA19-9 的汇总敏感性和特异性和 SROC 分别为 0.67（95%置信区间 0.61 至 0.72）、0.86（95%置信区间 0.75 至 0.93）和 0.75（95%置信区间 0.71 至 0.79）。MUC1 的汇总 HR 为 CCA 中的 2.20（95%置信区间 1.57 至 3.01）和块状形成性肝内 CCA 中的 4.17（95%置信区间 1.71 至 10.17）。