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首页> 外文期刊>Systematic Reviews >Diagnostic performance of alpha-fetoprotein, lens culinaris agglutinin-reactive alpha-fetoprotein, des-gamma carboxyprothrombin, and glypican-3 for the detection of hepatocellular carcinoma: a systematic review and meta-analysis protocol
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Diagnostic performance of alpha-fetoprotein, lens culinaris agglutinin-reactive alpha-fetoprotein, des-gamma carboxyprothrombin, and glypican-3 for the detection of hepatocellular carcinoma: a systematic review and meta-analysis protocol

机译：甲胎蛋白，晶状体凝集素反应性甲胎蛋白，des-γ羧化凝血酶原和glypican-3对肝细胞癌的诊断性能：系统评价和荟萃分析方案

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Background Diagnosis of early-stage hepatocellular carcinoma (HCC) followed by curative resection or liver transplantation offers the best chance for long-term patient survival. Clinically, ultrasonography has suboptimal sensitivity for detecting early-stage HCC. Several serological tests including alpha-fetoprotein (AFP), the ratio of lens culinaris agglutinin-reactive alpha-fetoprotein to total AFP (AFP-L3/AFP), des-gamma carboxyprothrombin (DCP), and glypican-3 (GPC-3) have been widely investigated as diagnostic biomarkers for early-stage HCC in at-risk populations. However, these tests are not recommended for routine HCC screening. Our objective is to determine the diagnostic performance of AFP, AFP-L3/AFP, DCP, and GPC-3 for the detection of HCC, particularly early-stage tumors meeting the Milan criteria. Methods/design We will include cross-sectional studies that consecutively or randomly recruit target populations. We will search the Cochrane Library, Medline, Embase, Science Citation Index, and the Chinese National Knowledge Infrastructure. We will also search the MEDION and ARIF databases to identify diagnostic systematic reviews that include primary studies. Reference lists of relevant reviews will be searched for additional trials. Language restrictions will not be applied. Two reviewers will independently screen study eligibility and extract data. Methodological quality will be assessed according to the revised tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Two authors will apply the QUADAS-2 assessment to all the included studies, and any discrepancies will be resolved by the third author. The following test characteristics will be extracted into 2 × 2 tables for all included studies: true positives, false positives, true negatives, and false negatives. Study-specific estimates of sensitivity and specificity with 95% confidence intervals will be displayed in forest plots. When possible, we will use the bivariate random-effects model or the Rutter and Gatsonis hierarchical summary receiver operating characteristic model for statistical analysis. To investigate heterogeneity, we will include study designs, population characteristics, test characteristics, and types of reference standard as the study-level variables. Discussion Our systematic review will allow patients, clinicians, and researchers to determine the diagnostic performance of AFP, AFP-L3/AFP, DCP, and GPC-3 for the detection of early-stage HCC and the potential roles of these diagnostic biomarkers in the existing diagnostic pathways. Systematic Review Registration: PROSPERO 2013; CRD42013003879
机译：背景技术早期肝细胞癌（HCC）的诊断，然后进行根治性切除或肝移植，为患者长期生存提供了最佳机会。在临床上，超声检查对检测早期HCC的敏感性欠佳。几种血清学检测，包括甲胎蛋白（AFP），眼镜球菌凝集素反应性甲胎蛋白与总AFP的比率（AFP-L3 / AFP），去γ羧化凝血酶原（DCP）和glypican-3（GPC-3）作为危险人群中早期肝癌的诊断生物标记物，已被广泛研究。但是，不建议将这些测试用于常规HCC筛查。我们的目标是确定AFP，AFP-L3 / AFP，DCP和GPC-3对HCC（尤其是符合米兰标准的早期肿瘤）的诊断性能。方法/设计我们将包括连续或随机招募目标人群的横断面研究。我们将搜索Cochrane图书馆，Medline，Embase，科学引文索引和中国国家知识基础设施。我们还将搜索MEDION和ARIF数据库，以识别包括基础研究在内的诊断性系统评价。将搜索相关评论的参考列表以进行其他试验。语言限制将不适用。两名审稿人将独立筛选研究资格并提取数据。方法学质量将根据修订后的诊断准确性研究质量评估工具（QUADAS-2）进行评估。两名作者将QUADAS-2评估应用于所有纳入的研究，任何差异将由第三名作者解决。对于所有纳入的研究，以下测试特征将被提取到2×2表中：真阳性，假阳性，真阴性和假阴性。特定研究的敏感性和特异性估计值（置信区间为95％）将显示在林区中。在可能的情况下，我们将使用双变量随机效应模型或Rutter和Gatsonis分级汇总接收机的工作特性模型进行统计分析。为了研究异质性，我们将包括研究设计，总体特征，测试特征和参考标准类型作为研究水平变量。讨论我们的系统评价将使患者，临床医生和研究人员可以确定AFP，AFP-L3 / AFP，DCP和GPC-3对早期肝癌的诊断性能以及这些诊断生物标志物在肝癌中的潜在作用。现有的诊断途径。系统审核注册：PROSPERO 2013; CRD42013003879

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