Abstract:
This study aimed to analyze the diagnostic performance of serum CA-125 in acute appendicitis (AA). This review was registered in PROSPERO (CRD42023450988). We included prospective and retrospective original clinical studies evaluating the diagnostic performance of serum CA-125 in AA. A search was conducted in PubMed, Web of Science, Scopus, and OVID. Search terms and keywords were: (appendicitis OR appendectomy) AND (CA-125 OR CA125). Two independent reviewers selected the articles and extracted relevant data. Methodological quality was assessed using the QUADAS-2 index. A synthesis of the results, standardization of the metrics, and three random-effect meta-analyses were performed. Five studies with data from 533 participants (including 219 patients with a confirmed diagnosis of AA and 107 controls) were included in this review. The random-effect meta-analysis of serum CA-125 (AA vs controls) included 3 articles (125 AA and 70 controls) and resulted in a non-significant mean difference [95% CI] of - 6.80 [- 20.51, 6.92] U/mL (p = 0.33). The meta-analysis by subgroups that included only male patients resulted in a significant mean difference [95% CI] of 3.48 [0.46, 6.49] U/mL (p = 0.02). Although serum CA-125 does not appear to be a good overall marker for the diagnosis of AA, our subgroup analyses show that this marker could be useful for diagnosing AA in males. It also appears to be a potentially useful tool for discriminating complicated and uncomplicated AA. However, the limited number of included studies precludes drawing generalizable conclusions. Future prospective studies focused on males and in its potential ability to discriminate between complicated and uncomplicated AA are required.Registration. PROSPERO (CRD42023450988).
摘要:
本研究旨在分析血清CA-125对急性阑尾炎(AA)的诊断价值。这篇评论在PROSPERO(CRD42023450988)中注册。我们纳入了前瞻性和回顾性原始临床研究,评估了血清CA-125在AA中的诊断性能。在PubMed进行了搜索,WebofScience,Scopus,和OVID。搜索词和关键词是:(阑尾炎或阑尾切除术)和(CA-125或CA125)。两名独立审稿人选择了文章并提取了相关数据。使用QUADAS-2指数评估方法学质量。结果的综合,指标的标准化,并进行了3项随机效应荟萃分析.该综述包括来自533名参与者(包括219名确诊为AA的患者和107名对照)的5项研究。血清CA-125(AA与对照)的随机效应荟萃分析包括3篇文章(125AA和70个对照),结果无显着平均差异[95%CI]为-6.80[-20.51,6.92]U/mL(p=0.33)。仅包括男性患者的亚组的荟萃分析导致3.48[0.46,6.49]U/mL的显着平均差异[95%CI](p=0.02)。尽管血清CA-125似乎不是诊断AA的良好总体标志物,我们的亚组分析表明,该标记可用于诊断男性AA.它似乎也是区分复杂和不复杂的AA的潜在有用工具。然而,纳入研究的数量有限,因此无法得出可概括的结论.未来的前瞻性研究侧重于男性及其区分复杂和不复杂AA的潜在能力。注册。PROSPERO(CRD42023450988)。