Fu Liang, Zhang Jiwang, Li Ling, Yang Yuxing, Yuan Yongqiang
Clinical Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, P.R. China.
Department of Pathology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, Xinjiang 830001, P.R. China.
Oncol Lett. 2020 Feb;19(2):1165-1174. doi: 10.3892/ol.2019.11227. Epub 2019 Dec 18.
Survivin is a promising marker for the diagnosis of bladder cancer. The accuracy and clinical value of urinary survivin mRNA expression were compared with urine cytology, which is the standard diagnostic method for bladder cancer. Scientific databases, including PubMed, Web of Science, Cochrane Library and China National Knowledge Infrastructure, were searched in order to find studies that examined urinary survivin mRNA expression and urine cytology in the diagnosis of bladder cancer. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool in Revman 5.3 and data analysis was conducted using Stata/MP. The I statistic was used to evaluate heterogeneity and Deeks' funnel plot was generated to assess the possibility of publication bias. A total of 15 studies that evaluated a total of 1,624 patients were included in the present meta-analysis. The pooled sensitivity and specificity values for the detection of urinary survivin mRNA expression in the diagnosis of bladder cancer were 0.86 [95% confidence interval (CI), 0.81-0.90] and 0.95 (95% CI, 0.93-0.96), respectively. Regarding urine cytology, the pooled sensitivity and specificity values were 0.42 (95% CI, 0.36-0.48) and 1.00 (95% CI, 0.98-1.00), respectively. Furthermore, the differences in pooled sensitivity were statistically significant in the diagnosis of grade 1 and 2 bladder tumors. Summary receiver operating characteristic curve values for urinary survivin mRNA expression and urine cytology were 0.95 (95% CI, 0.93-0.97) and 0.86 (95% CI, 0.83-0.89), respectively. Urinary survivin mRNA expression was also more accurate compared with other diagnostic indicators, including positive likelihood ratios, negative likelihood ratios, diagnostic odds ratios and Youden's index. Compared with traditional urine cytology, urinary survivin mRNA detection using reverse transcription-PCR was identified to be more effective in the diagnosis of early bladder cancer.
生存素是一种很有前景的膀胱癌诊断标志物。将尿生存素mRNA表达的准确性和临床价值与尿细胞学检查（膀胱癌的标准诊断方法）进行了比较。检索了包括PubMed、科学网、Cochrane图书馆和中国知网在内的科学数据库，以查找研究尿生存素mRNA表达和尿细胞学检查在膀胱癌诊断中的应用的研究。使用Revman 5.3中的诊断准确性研究质量评估2工具进行质量评估，并使用Stata/MP进行数据分析。采用I统计量评估异质性，并生成Deeks漏斗图以评估发表偏倚的可能性。本荟萃分析共纳入15项评估了1624例患者的研究。尿生存素mRNA表达检测在膀胱癌诊断中的合并敏感性和特异性值分别为0.86 [95%置信区间（CI），0.81 - 0.90]和0.95（95%CI，0.93 - 0.96）。对于尿细胞学检查，合并敏感性和特异性值分别为0.42（95%CI，0.36 - 0.48）和1.00（95%CI，0.98 - 1.00）。此外，在1级和2级膀胱肿瘤的诊断中，合并敏感性的差异具有统计学意义。尿生存素mRNA表达和尿细胞学检查的汇总受试者工作特征曲线值分别为0.95（95%CI，0.93 - 0.97）和0.86（95%CI，0.83 - 0.89）。与其他诊断指标（包括阳性似然比、阴性似然比、诊断比值比和尤登指数）相比，尿生存素mRNA表达也更准确。与传统尿细胞学检查相比，使用逆转录 - PCR检测尿生存素mRNA在早期膀胱癌诊断中更有效。
