Zhang Guangying, Li Zhanzhan, Zhou Qin
Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Front Oncol. 2019 Dec 19;9:1391. doi: 10.3389/fonc.2019.01391. eCollection 2019.
We collected previous published data and performed a systematical assessment for the diagnostic value of serum Zta antibody in NPC patients. Using bivariate-mixed effect model, we calculated the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnosis odds ratio (DOR), and summary receiver operating characteristics curve (AUC) and their 95% confidence intervals (CIs). We also performed subgroup analysis to explore the heterogeneity. We included 23 studies including 24 pieces of data and 17,770 study subjects (2,126 cases and 15,644 controls). The overall combined sensitivity was 0.85 (95%CI: 0.80-0.89) and the combined specificity was 0.90 (95%CI: 0.87-0.93). The summarized AUC was 0.94 with 95%CI of 0.92-0.96. The PLR was 8.9 (95%CI: 6.4-12.2) and the NLR was 0.17(95%CI: 0.12-0.23). The diagnostic odds ratio was 53 (95%CI: 32-87). For publication year, the sensitivity was 0.88 (95%CI: 0.84-0.91) and the specificity was 0.90 (95%CI: 0.84-0.93) for ≤2006. The AUC, PLR, NLR and DOR were 0.94, 8.8, 0.13, and 64. The pooled results were similar for >2006 group. For different sample size, the pooled AUC was 0.94 for ≤Median and was 0.95 for >Median that were very close to the overall estimations. For different population setting, no overlap was found in the sensitivity (0.84 vs. 0.87), specificity (0.90 vs. 0.84), PLR (8.7 vs. 5.5), NLR (0.16 vs. 0.08-0.33), DOR (49 vs. 35), and AUC (0.94 vs. 0.92) between Asian and others. The serum EBV antibody examination has high diagnostic accuracy for early-stage NPC. The diagnostic accuracy seems not to be influenced by sample size, publication year, and ethnic. Considering the few numbers of study with non-Asian population, the present results need to be confirmed in other population setting.
我们收集了先前发表的数据，并对血清Zta抗体在鼻咽癌患者中的诊断价值进行了系统评估。使用双变量混合效应模型，我们计算了敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）以及汇总的受试者工作特征曲线（AUC）及其95%置信区间（CI）。我们还进行了亚组分析以探索异质性。我们纳入了23项研究，包括24条数据和17770名研究对象（2126例病例和15644名对照）。总体合并敏感性为0.85（95%CI：0.80 - 0.89），合并特异性为0.90（95%CI：0.87 - 0.93）。汇总的AUC为0.94，95%CI为0.92 - 0.96。PLR为8.9（95%CI：6.4 - 12.2），NLR为0.17（95%CI：0.12 - 0.23）。诊断比值比为53（95%CI：32 - 87）。对于发表年份，≤2006年时敏感性为0.88（95%CI：0.84 - 0.91），特异性为0.90（95%CI：0.84 - 0.93）。AUC、PLR、NLR和DOR分别为0.94、8.8、0.13和64。>2006年组的汇总结果相似。对于不同样本量，≤中位数时汇总的AUC为0.94，>中位数时为0.95，与总体估计值非常接近。对于不同人群设置，亚洲人群与其他人群在敏感性（0.84对0.87）、特异性（0.90对0.84）、PLR（8.7对5.5）、NLR（0.16对0.08 - 0.33）、DOR（49对35）和AUC（0.94对0.92）方面均无重叠。血清EBV抗体检测对早期鼻咽癌具有较高的诊断准确性。诊断准确性似乎不受样本量、发表年份和种族的影响。鉴于非亚洲人群的研究数量较少，目前的结果需要在其他人群设置中得到证实。
