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目的系统评价EB病毒Zta抗体检测用于鼻咽癌诊断的准确性。方法全文检索中国期刊全文数据库(CNKI,1979-2012)、万方数据知识平台(1990-2012)、维普出版平台(1989-2012)和PubMed(1966-2012),结合手动检索,按照纳入和排除标准筛选文献,提取纳入文献的诊断准确性指标的数据。按QUADAS量表对纳入研究进行质量评价,采用MetaDisc 1.4软件检验研究间的异质性,并对诊断准确性指标进行Meta分析,绘制综合受试者工作特征曲线。结果从202篇中文文献和31篇英文文献中筛选出17篇符合标准的文献,总计鼻咽癌病例1 645例,对照组10 177例。研究间各诊断准确性指标均存在高度异质性,采用随机效应模型合并计算各诊断准确性评价指标。合并灵敏度为0.87(95%CI:0.86～0.89),合并特异度为0.94(95%CI:0.93～0.94),合并阳性似然比为8.05(95%CI:5.59～11.59),合并阴性似然比为0.16(95%CI:0.12～0.21),合并诊断优势比为52.93(95%CI:29.95～93.56),综合受试者工作曲线下面积为0.935 2。亚组分析显示在对照为其他EB相关疾病的研究中,诊断特异度为0.71(95%CI:0.66～0.76),低于对照为一般人群的研究。结论 EB病毒Zta IgG抗体检测用于鼻咽癌诊断的准确性较高,特别是在鼻咽癌筛查中具有很高的特异度,该检测具有良好的应用前景,应加强研制开发该种检测的体外诊断试剂盒。
Objective To evaluate the diagnostic accuracy of Epstein-Barr virus Zta antibody for the diagnosis of nasopharyngeal carcinoma. Methods Full-text search of Chinese Journal Full-text Database (CNKI, 1979-2012), Wanfang Data Knowledge Platform (1990-2012), VIP Publishing Platform (1989-2012) and PubMed (1966-2012), combined with manual retrieval, Standard screening literature to extract data included in the diagnostic accuracy of the literature. The QUADAS scale was used to evaluate the quality of the included studies. MetaDisc 1.4 software was used to test the heterogeneity among the studies. Meta-analysis was performed on the indicators of diagnostic accuracy and the working curve of the comprehensive subjects was drawn. Results A total of 17 published papers were screened out from 202 Chinese and 31 English articles, accounting for 1645 cases of NPC and 10 177 cases of control. All the diagnostic accuracy indicators of the study are highly heterogeneous, using random effects model combined calculation of diagnostic accuracy of each evaluation index. The combined sensitivity was 0.87 (95% CI: 0.86-0.89) and the combined specificity was 0.94 (95% CI: 0.93-0.94). The combined positive likelihood ratio was 8.05 (95% CI: 5.59-11.59) The odds ratio (OR) was 0.16 (95% CI: 0.12-0.21). The pooled diagnostic odds ratio was 52.93 (95% CI: 29.95-93.56). The area under the working curve of the composite subjects was 0.9352. Subgroup analyzes showed a specificity of 0.71 (95% CI: 0.66 to 0.76) for the control study for other EB-related diseases, lower than the control study for the general population. Conclusion The detection of Epstein-Barr virus Zta IgG antibody has high accuracy for the diagnosis of nasopharyngeal carcinoma, especially for the screening of nasopharyngeal carcinoma, which has good application prospect and should be further developed In vitro diagnostic kit.