UNASSIGNED：胃癌（GC）是人类最常见的恶性肿瘤之一。癌胚抗原(CEA),糖类抗原(CA)19-9和CA72-4均为胃癌诊断的血清肿瘤标志物。然而,报告三者合并诊断的研究结果各不相同.在这项研究中,系统评价了这3种血清肿瘤标志物的联合诊断性能.
未经授权：PubMed，Embase,科克伦图书馆,中国国家知识基础设施(CNKI),和万方数据搜索有关血清肿瘤标志物CEA的文献，CA19-9和CA72-4在胃癌诊断中的应用.纳入标准是根据参与者设计的，干预,Control,结果，研究（PICOS）原则。使用诊断准确性研究质量评估（QUADAS）评分量表评估文献质量。提取数据后，采用Stata16.0软件进行Meta分析。
UNASSIGNED：最终共收录了10篇文章，共有6574名患者参与诊断，确认的GC分别为3,077,非GC分别为3,497。Meta分析结果显示,3种肿瘤标志物联合诊断的诊断灵敏度为0.67[95%置信区间(CI):0.54,0.77],特异性为0.89（95%CI：0.82，0.93），阳性似然比为5.9（95%CI：3.5，9.8），负似然比为0.38（95%CI：0.27，0.53），诊断比值比（DOR）为16（95％CI：8，32）。单独诊断CA72-4的敏感性为0.58(95%CI:0.40,0.73),特异性为0.86（95%CI：0.80，0.90），阳性似然比为4.0（95%CI：3.1，5.1），负似然比为0.49（95%CI：0.34，0.71），DOR为8（95%CI：5，14）。联合三项诊断和单独CA72-4诊断的ROC曲线下面积(AUC)值分别为0.87(95%CI:0.83,0.89)和0.84(95%CI:0.81,0.87),分别,差异有统计学意义(Z=4.86,P<0.05)。
UNASSIGNED：在胃癌的诊断中，3种肿瘤标志物的联合使用比单一标志物诊断具有更高的敏感性和特异性。
UNASSIGNED: Gastric cancer (GC) is one of the most common malignant tumors in humans. Carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and CA72-4 are all serum tumor markers for diagnosis of gastric cancer. However, the results of studies reporting the diagnosis of the combined three varied. In this study, the combined diagnostic performance of these 3 serum tumor markers was systematically evaluated.
UNASSIGNED: PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang data were searched for literature on serum tumor markers CEA, CA19-9, and CA72-4 in the diagnosis of gastric cancer. The inclusion criteria were designed according to the Participants, Intervention, Control, Outcomes, Study (PICOS) principles. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) scoring scale was used to assess the quality of the literature. After extracting the data, Stata 16.0 software was used for meta-analysis.
UNASSIGNED: A total of 10 articles were finally included, and a total of 6,574 patients participated in diagnosis, 3,077 for confirmed GC and 3,497 for non-GC respectively. Meta-analysis results showed that the diagnostic sensitivity of the combined diagnosis of the 3 tumor markers was 0.67 [95% confidence interval (CI): 0.54, 0.77], the specificity was 0.89 (95% CI: 0.82, 0.93), the positive likelihood ratio was 5.9 (95% CI: 3.5, 9.8), the negative likelihood ratio was 0.38 (95% CI: 0.27, 0.53), and the diagnostic odds ratio (DOR) was 16 (95% CI: 8, 32). The diagnostic sensitivity of CA72-4 diagnosis alone was 0.58 (95% CI: 0.40, 0.73), specificity was 0.86 (95% CI: 0.80, 0.90), the positive likelihood ratio was 4.0 (95% CI: 3.1, 5.1), the negative likelihood ratio was 0.49 (95% CI: 0.34, 0.71), and the DOR was 8 (95% CI: 5, 14). The area under the ROC curve (AUC) values of the combined three diagnosis and CA72-4 diagnosis alone were 0.87 (95% CI: 0.83, 0.89) and 0.84 (95% CI: 0.81, 0.87), respectively, the difference was statistically significant (Z=4.86, P<0.05).
UNASSIGNED: The combined use of the 3 tumor markers has higher sensitivity and specificity than single marker diagnosis in the diagnosis of gastric cancer.
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