Value of serum AFP,CEA and CA19-9 detection in opportunistic screening for liver cancer in Chinese population:a meta-analysis
Objective To evaluate the value of detection of serum alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)in opportunistic screening of liver cancer in Chinese population with a meta-analysis.Methods Literatures on combined screening of liver cancer by AFP,CEA and CA19-9 were retrieved from CNKI,Wanfang Database,Chongqing VIP database,PubMed,Embase and Cochrane Library from the establishment of the databases to June 2023.The Quality Assessment Tool of Diagnostic Accuracy Studies(QUADAS-2)was used to evaluate the quality of the literature.Stata 17.0 statistical software was used for meta-analysis,and Deeks funnel plot was used to analyze publication bias.Results A total of 24 literatures met the inclusion criteria,including 1471 patients with liver cancer and 2 150 controls.The overall sensitivity of AFP in liver cancer diagnosis(screening)was 0.71(95％CI:0.66-0.75),the total specificity was 0.86(95％CI:0.80-0.90),and the area under summary receiver operating characteristic(sROC)curve(AUC)was 0.82(95％CI:0.78-0.85).The total sensitivity of CEA in liver cancer diagnosis(screening)was 0.48(95％CI:0.40-0.56),the total specificity was 0.85(95％CI:0.79-0.89),and the AUC of sROC was 0.74(95％CI:0.70-0.77).The total sensitivity of CA19-9 in liver cancer diagnosis(screening)was 0.56(95％CI:0.50-0.61),the total specificity was 0.80(95％CI:0.73-0.85),and the AUC was 0.69(95％CI:0.65-0.73).AFP has the highest sensitivity and specificity among the three.The overall sensitivity of combined detection of AFP,CEA and CA19-9 for liver cancer diagnosis(screening)was increased to 0.89(95％CI:0.85-0.92),the overall specificity was 0.77(95％CI:0.70-0.82),and the AUC was 0.91(95％CI:0.88-0.93).No publication bias was found in either individual or combined test of the biomarkers.Conclusions Detection of AFP alone has high sensitivity and specificity,and it is a tumor marker that can be used for the opportunistic screening of liver cancer.When combined tests of AFP,CEA and CA19-9 are used to screen liver cancer,the results should be interpreted more carefully.
万方数据
维普
