摘要
目的评价血清神经元烯醇化酶(NSE)水平对小细胞肺癌患者的预后影响。方法计算机检索MEDLINE、EMbase、CBMdisc、Cochrane Central Register of Controlled Trials等数据库,并从符合纳入标准的文献中查找相关文献。检索时间从1950年到2007年12月。由2名评价者独立检索、评价文献交叉核对后提取有效数据进行Meta分析。结果共纳入9个研究共2021例小细胞肺癌患者。按作者对NSE水平的截断值,其中66.0%(36.5%～79%)的病例血清NSE浓度呈现高水平。NSE浓度高水平对患者的危害是NSE低水平的1.27倍[95%CI(1.19,1.35),P=0.281]。结论治疗前NSE浓度高水平患者预后总生存率较NSE低水平患者差,NSE水平对小细胞肺癌预后有一定的预测价值。但由于本研究纳入文献可能存在发表偏倚、选择偏倚、测量偏倚的高度可能性,上述结论应慎重对待。期待更多高质量、同质性的研究来精确评价NSE的预后价值。
Objective To evaluate the prognostic value of the level of serum neurone specific enolase （NSE） in patients with small cell lung cancer （SCLC）. Methods We searched MEDLINE, EMbase, CBMdisc, and The Cochrane Central Register of Controlled Trials （1950 to December 2007）. Studies meeting the eligibility criteria were retrieved and their bibliographies were checked for other relevant publications. The quality of included studies was evaluated by 2 reviewers independently. Meta-analyses were performed for the results of homogeneous studies using STATA 7.0 software. Results Nine studies involving 2 021 SCLC patients were included. About 66.0% of patients had high serum levels of NSE, according to the cut-off value defined by the authors. The hazard ratio （HR） of high levels of NSE for overall survival （OS） was 1.27 times of that of low levels of NSE for OS in SCLC patients （95% CI 1.19 to 1.35, P=0.281）. Conclusion Patients with high levels of NSE appear to have a poorer OS compared with those with low levels of NSE, thus the level of NSE has a prognostic value in SCLC patients. Due to the potential publication bias, selection bias, and measurement bias among these studies, the conclusion should be interpreted carefully. More high-quality homogeneous studies are required to accurately evaluate the prognostic value of NSE.
出处
《中国循证医学杂志》
CSCD
2009年第1期76-80,共5页
Chinese Journal of Evidence-based Medicine
关键词
神经元烯醇化酶
小细胞肺癌
预后
系统评价
Neurone specific enolase
Small cell lung cancer
Prognosis
Systematic Review
