摘要:目的:采用Meta分析的方法評(píng)價(jià)甲狀腺球蛋白在甲狀腺良性疾病和甲狀腺癌中的臨床意義。方法:通過檢索MEDLINE、EMBASE、The Cochrane Library, 中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)和其他方式廣泛收集文獻(xiàn)。根據(jù)QUADAS質(zhì)量評(píng)價(jià)標(biāo)準(zhǔn)評(píng)價(jià)納入文獻(xiàn)的質(zhì)量,用MetaDisc軟件對(duì)其敏感度、特異度、陽(yáng)性似然比、陰性似然比等進(jìn)行合并分析,并進(jìn)行異質(zhì)性檢驗(yàn),繪制綜合受試者工作特征曲線(summary receiver operator characteristic curve,SROC)。結(jié)果:最終納入5篇文獻(xiàn)。合并敏感度0.60,合并特異度0.83,合并比值比2.68, SROC下面積(AUC)=0.645 4。結(jié)論:現(xiàn)有研究證實(shí):甲狀腺球蛋白在甲狀腺癌中的陽(yáng)性率是甲狀腺良性疾病中的2.68倍,有統(tǒng)計(jì)學(xué)差異,但敏感度不高。尚需更多設(shè)計(jì)嚴(yán)謹(jǐn)、科學(xué)的臨床試驗(yàn)進(jìn)一步證實(shí)。
Abstract: Objective: To evaluate the quality of the current studies involving the value of serum thyroglobulin in the diagnosis of thyroid benign diseases and thyroid carcinoma. Methods: We comprehensive collected current studies about serum thyroglobulin in thyroid benign diseases and thyroid carcinoma by computer and manual searches. QUADAS items were used for quality assessment in our systematic review. Metadisc software was used to analyze pooled sensitivity, pooled specificity,pooled positive likelihood ratio and pooled negative likelihood ratio,pooled diagnostic test odds ratio and heterogeneity test,and draw summary receiver operator characteristic curve (SROC). Results: Totally 5 studies were included. To identify thyroid benign diseases and thyroid carcinoma, pooled sensitivity was 0.60, pooled specificity was 0.83,pooled odds ratio was 2.68, the area under curve (AUC) was 0.645 4.Conclusion: The results of statistic alanalysis showed that the positive rate of thyroglobulin in thyroid carcinoma is 2.68 times more than in benign thyroid diseases. There was significant difference. But sensitivity was not high and reporting quality of the studies was relatively poor. The conclusion still need more clinical trials to confirm.

引用本文： 高杰,安振梅. 甲狀腺球蛋白在甲狀腺疾病中臨床意義的系統(tǒng)評(píng)價(jià). 華西醫(yī)學(xué), 2009, 24(11): 2907-2910. doi: 復(fù)制