背景:鼻咽癌(NPC)诊断相对较晚,预后较差,需要早期检测以减轻疾病负担。这项诊断测试准确性荟萃分析评估了9个EBV相关IgA抗体组(EBNA1-IgA,VCA-IgA,EA-IgA,Zta-IgA,EBNA1-IgA+VCA-IgA,VCA-IgA+EA-IgA,VCA-IgA+Rta-IgG,EBNA1-IgA+VCA-IgA+Zta-IgA和VCA-IgA+EA-IgA+Rta-IgG),旨在为NPC筛查确定合适的血清学检测生物标志物。
方法:PubMed,Embase,从1月1日起检索中国国家知识基础设施和中国生物医学文献数据库,2000年9月30日,2023年,关键词是鼻咽癌,IgA,筛选,早期发现,早期诊断,敏感性和特异性。包括有关血清EBV相关IgA抗体组对NPC的诊断价值的文章。研究选择,数据提取,质量评估由两名研究人员独立进行,在分歧的情况下,咨询了第三位研究人员。使用双变量模型进行统计分析。通过诊断准确性研究质量评估工具(QUADAS-2)评估纳入研究的质量。
结果:共包括70篇文章,涉及11863例NPC病例和34995例对照。在9个EBV相关的IgA抗体组中,EBNA1-IgA+VCA-IgA[0.928(0.898,0.950)],VCA-IgA+Rta-IgG[0.925(0.890,0.949)],EBNA1-IgA+VCA-IgA+Zta-IgA[0.962(0.909,0.985)]和VCA-IgA+EA-IgA+Rta-IgG[0.945(0.918,0.964)]表现出更高的合并敏感性(95CI)。就诊断优势比(DOR)(95CI)而言,EBNA1-IgA+VCA-IgA[107.647(61.173,189.430)],VCA-IgA+Rta-IgG[105.988(60.118,186.857)]和EBNA1-IgA+VCA-IgA+Zta-IgA[344.450(136.351,870.153)]表现优越。此外,EBNA1-IgA+VCA-IgA和VCA-IgA+Rta-IgG的SROC曲线更有利。然而,检测到VCA-IgA(P=0.005)和EBNA1-IgA+VCA-IgA(P=0.042)的发表偏倚.
结论:一般来说,血清EBNA1-IgA的平行检测,使用ELISA的VCA-IgA和Zta-IgA抗体在所研究的组中显示出更好的合并敏感性和DOR。在使用较少的指标的情况下,血清VCA-IgA和EBNA1-IgA/Rta-IgG抗体组表现出相当的性能。
背景:系统评论国际前瞻性注册登记号:CRD42023426984,注册于2023年5月28日。
BACKGROUND: Nasopharyngeal carcinoma (NPC) is diagnosed relatively late and has a poor prognosis, requiring early detection to reduce the disease burden. This diagnostic test accuracy meta-analysis evaluated the serological diagnostic value of nine EBV-related IgA antibody panels (EBNA1-IgA, VCA-IgA, EA-IgA, Zta-IgA, EBNA1-IgA + VCA-IgA, VCA-IgA + EA-IgA, VCA-IgA + Rta-IgG, EBNA1-IgA + VCA-IgA + Zta-IgA and VCA-IgA + EA-IgA + Rta-IgG), aiming to identify suitable serological detection biomarkers for NPC screening.
METHODS: PubMed, Embase, China National Knowledge Infrastructure and Chinese BioMedical Literature Database were searched from January 1st, 2000 to September 30th, 2023, with keywords nasopharyngeal carcinoma, IgA, screening, early detection, early diagnosis, sensitivity and specificity. Articles on the diagnostic value of serum EBV-related IgA antibody panels for NPC were included. Study selection, data extraction, and quality assessment were performed independently by two researchers, and a third researcher was consulted in the case of disagreement. Bivariate models were used for statistical analysis. The quality of included studies was evaluated through Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2).
RESULTS: A total of 70 articles were included, involving 11 863 NPC cases and 34 995 controls. Among the nine EBV-related IgA antibody panels, EBNA1-IgA + VCA-IgA [0.928 (0.898, 0.950)], VCA-IgA + Rta-IgG [0.925 (0.890, 0.949)], EBNA1-IgA + VCA-IgA + Zta-IgA [0.962 (0.909, 0.985)] and VCA-IgA + EA-IgA + Rta-IgG [0.945 (0.918, 0.964)] demonstrated higher pooled sensitivity (95%CI). In terms of diagnostic odds ratio (DOR) (95%CI), EBNA1-IgA + VCA-IgA [107.647 (61.173, 189.430)], VCA-IgA + Rta-IgG [105.988 (60.118, 186.857)] and EBNA1-IgA + VCA-IgA + Zta-IgA [344.450 (136.351, 870.153)] showed superior performance. Additionally, the SROC curves for EBNA1-IgA + VCA-IgA and VCA-IgA + Rta-IgG were more favorable. However, publication bias was detected for VCA-IgA (P = 0.005) and EBNA1-IgA + VCA-IgA (P = 0.042).
CONCLUSIONS: In general, parallel detection of serum EBNA1-IgA, VCA-IgA and Zta-IgA antibodies using ELISA demonstrates better pooled sensitivity and DOR among the studied panels. In the cases where fewer indicators are used, serum VCA-IgA and EBNA1-IgA/Rta-IgG antibody panel exhibits a comparable performance.
BACKGROUND: The International Prospective Register of Systematic Reviews registration number: CRD42023426984, registered on May 28, 2023.