中国循证医学杂志

中国循证医学杂志

骨代谢指标 ICTP 对肺癌骨转移诊断价值的 Meta 分析

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目的系统评价骨代谢指标 Ⅰ 型胶原吡啶交联终肽(cross-linked carboxy-terminal telopeptide of type I collagen,ICTP)在肺癌骨转移中的诊断价值。方法计算机检索 The Cochrane Library、PubMed、EMbase、WanFang Data 和 CBM 数据库,搜集 ICTP 诊断肺癌骨转移的相关研究,检索时限均从建库至 2017 年 11 月。由 2 名研究者独立筛选文献、提取资料并采用 QUADAS-2 工具评价纳入研究的偏倚风险后,使用 Meta-Disc 1.4 软件进行 Meta 分析。结果共纳入 8 个研究,包括 781 例患者。Meta 分析结果显示:ICTP 诊断肺癌骨转移的合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比和 SROC 曲线下面积分别为 71%[95%CI(0.65,0.76)]、80%[95%CI(0.76,0.84)]、3.79[95%CI(2.31,6.21)]、0.35[95%CI(0.25,0.49)]、14.67[95%CI(6.99,30.81)]和0.860 3。结论ICTP 对肺癌骨转移具有一定的诊断价值,协同骨扫描等影像学方法有助于进行诊断。受纳入研究的数量和质量的限制,上述结论尚需开展更多研究予以证实。

ObjectivesTo systematically review the value of cross-linked carboxy-terminal telopeptide of type I collagen (ICTP) in the diagnosis of bone metastases of lung cancer.MethodsThe Cochrane Library, PubMed, EMbase, WanFang Data and CBM databases were electronically searched to collect studies on ICTP in the diagnosis of lung cancer bone metastases from inception to November 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by QUADAS-2 standard. Meta-analysis was performed by using Meta-Disc 1.4 software.ResultsA total of 8 studies involving 781 patients were included. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and area under the curve of summary receiver operating characteristics were 71% (95%CI 0.65 to 0.76), 80% (95%CI 0.76 to 0.84), 3.79 (95%CI 2.31 to 6.21), 0.35 (95%CI 0.25 to 0.49), 14.67 (95%CI 6.99 to 30.81) and 0.860 3, respectively.ConclusionsICTP cooperate with imaging tests may be accurate and practical in diagnosis of bone metastases of lung cancer. Due to the limited quality and quantity of included studies, the above results should be validated by more studies.

关键词: Ⅰ 型胶原吡啶交联终肽; 肺癌; 骨转移; 诊断价值; Meta 分析; 系统评价

Key words: ICTP; Lung cancer; Bone metastases; Diagnostic value; Meta-analysis; Systematic review

引用本文: 郎江莉, 赵茜, 余希杰. 骨代谢指标 ICTP 对肺癌骨转移诊断价值的 Meta 分析. 中国循证医学杂志, 2018, 18(8): 816-821. doi: 10.7507/1672-2531.201711055 复制

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