热休克蛋白90α在肺癌患者中诊断价值的荟萃分析

Meta-Analysis of Diagnostic Value of Heat Shock Protein 90α in Lung Cancer Patients

摘要: 目的：肺癌是临床上最为常见的恶性肿瘤，晚期患者预后差，5年生存率低，因此早期诊断成为提高患者预后的关键。本研究旨在评价热休克蛋白90α在肺癌诊断中的应用价值。方法：计算机检索中国知网、万方、维普、PubMed、Embase等数据库，搜索有关热休克蛋白90α与肺癌相关的研究，检索时间均从建库至2023年8月，并根据纳入与排除标准进行文献筛选。采用Meta-Disc1.4、RevMan5.4和Stata16.0软件进行了偏倚风险、适用性评价、Meta分析、回归分析、亚组分析、发表偏倚、敏感性分析和临床应用价值等统计学分析。结果：最终纳入文献18篇，综合各项数据后，采用随机效应模型进行分析。热休克蛋白90α诊断肺癌的合并敏感度为0.76 (95% CI: 0.680.83)，合并特异性为0.81 (95% CI: 0.730.87)，合并阳性似然比为3.98 (95% CI: 2.805.57)，合并阴性似然比为0.29 (95% CI: 0.220.39)，合并诊断比值比为13 (95% CI: 822)，综合受试者工作特征(SROC)曲线下面积为0.85。费根(Fagan)列线图显示，设定验前概率为50%，诊断肺癌的符合率为80%。结论：血液标本中热休克蛋白90α的表达水平有助于肺癌的临床诊断，可作为辅助诊断肺癌的分子生物学标志物。

Abstract: Objective: Lung cancer is the most common malignant tumor in clinic. The prognosis of advanced patients is poor and the 5-year survival rate is low, so early diagnosis is the key to improve the prognosis of patients. The purpose of this study was to evaluate the value of heat shock protein 90α (HSP90α) in the diagnosis of lung cancer. Methods: A systematic search was performed in databases of CNKl, WANFANGDATA, VIP, PubMed and Embase to find studies on the relationship between heat shock protein 90α and lung cancer published before August 2023, and the literatures were screened according to the inclusion and exclusion criteria. All the statistical analyses, bias risk, ap-plicability evaluation, Meta analysis, regression analysis, subgroup analysis, publication bias, sensi-tivity analysis and clinical application value were performed using Meta-Disc1.4, RevMan5.4 and Stata16.0. Results: A total of 18 studies were involved in this meta-analysis. The random effect model was used for analysis. The combined sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of HSP90α in the diagnosis of lung cancer were 0.76 (95% CI: 0.680.83), 0.81 (95% CI: 0.730.87), 3.98 (95% CI: 2.805.57), 0.29 (95% CI: 0.220.39) and 13 (95% CI: 822) respectively. The area under the curve of comprehensive subject working characteristics (SROC) was 0.85. The Fagan nomogram demonstrated that when diagnosing lung cancer supplemented by HSP90α, the post-test probability increased up to 80% from the setting pre-test probability of 50%. Conclusion: The expression level of HSP90α in blood samples is helpful for the clinical diagnosis of lung cancer and can be used as a molecular biological marker for the di-agnosis of lung cancer.