ABSTRACT
ObjectiveTo investigate the value of MELD combined with serum sodium concentration (MELD-Na) in predicting the short-term outcome of patients with HBV-related acute-on-chronic liver failure (ACLF) in China. MethodsPubMed, Embase, CNKI, VIP, and Wanfang Data were searched for related articles in English and Chinese published from January 2006 to March 2018. The second version of Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to evaluate the quality of each article. The presence or absence of threshold effect was examined. According to the presence or absence of heterogeneity, a random effect model or a fixed effect model was used for pooling sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR). The receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was calculated. The Deek’s funnel plot asymmetry test was used to investigate the presence or absence of publication bias. ResultsA total of eight studies were included, with a total of 1386 patients, among whom there were 1173 (84.6%) male patients. The mean age of the patients included in these studies ranged from 41.3 to 46.9 years. The tests for heterogeneity showed significant heterogeneity between studies and a random effect model was used for pooling. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR were 0.67 (95% confidence interval ［CI］: 0.59-0.75), 0.77 (95%CI: 0.63-0.87), 2.89 (95%CI: 1.84-4.54), 0.43 (95%CI: 0.35-0.52), and 7.32 (95%CI: 4.33-12.40), respectively. The AUC was 0.75 (95CI: 0.72-0.79). The Deek’s funnel plot asymmetry test showed no significant publication bias. ConclusionMELD-Na score has a certain value in predicting the short-term outcome of patients with HBV-related ACLF in China.
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Objective To investigate the clinical significance of serum pepsinogen (PG) in gastric cancer screening. Methods The clinical data of 930 patients underwent colonoscopy were retrospectively analyzed. Among them, non chronic atrophic gastritis was in 550 cases (chronic atrophic gastritis group), chronic atrophic gastritis in 300 cases (chronic atrophic gastritis group), gastric cancer in 80 cases (gastric cancer group). The patients in chronic atrophic gastritis group were divided into mild chronic atrophic gastritis subgroup (100 cases), moderate chronic atrophic gastritis subgroup (120 cases) and severe chronic atrophic gastritis subgroup (80 cases) according to the severity of the atrophy. The levels of serum PGⅠand PGⅡwere detected by enzyme linked immunosorbent assay (ELISA) method, and the ratio of PGⅠand PGⅡ(PGR) was calculated. Results There was no statistical difference in PGⅡ among the 3 groups (F = 1.226, P>0.05). The PG Ⅰand PGR in gastric cancer group were significantly lower than those in chronic atrophic gastritis and non chronic atrophic gastritis:(70.41 ± 39.42)μg/L vs. (83.10 ± 30.08) and (165.5 ± 41.40)μg/L, 3.76 ± 2.03 vs. 5.08 ± 1.82 and 6.84 ± 1.88, those in chronic atrophic gastritis were significantly lower than those in non chronic atrophic gastritis group, there were statistical differences (P0.05), and there was no statistical difference between mild chronic atrophic gastritis subgroup and moderate chronic atrophic gastritis subgroup (P>0.05). The receiver operating characteristic (ROC) curve was used, the optimal critical value of PG Ⅰ was 74.8μg/L, the area under curve (AUC) was 0.842, the sensitivity was 90%, specificity was 75%;the optimal critical value of PGR was 4.46, AUC was 0.837, the sensitivity was 75%, specificity was 82%;the AUC of combined detection of PG Ⅰ and PGR was 0.906, the sensitivity was 88%, specificity was 85%. Conclusions Detection of PG Ⅰ combined with PGR can be used as gastric cancer screening, the recommended level of PGⅠ≤74.80μg/L and PGR≤4.46.
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Objective To investigate the diagnostic value of serum homocysteine in the diagnosis of colon cancer.Methods The performance rate method was used to detect the level of serum homocysteine(Hcy) in colon cancer group(50 cases) who were treated in Beijing Tiantan Hospital Affiliated to Capital Medical University from March 2011 to June 2016 and control group(50 cases).The expression of independent samples t test was used to analysis of the difference of the Hcy levels between the two groups.The ROC curve was used to evaluate the value of Hcy in diagnosis of colon cancer.Results The serum Hcy level in colon cancer group was (18.6±8.9) μmol/L,in healthy control group was (10.7±4.3) μmol/L,colon cancer group serum Hcy levels were significantly higher than those of healthy control group,there was significant difference(t=5.627,P<0.01).AUC of ROC curve was 0.775,cut-off value of 18.5 μmol/L,sensitivity was 0.50,specificity was 0.94,95%CI was 0.682-0.868(P<0.01).Conclusion Serum Hcy can be used as a reference index of the diagnosis of colon cancer.