Application value of serum CEA, CA19-9 and CA242 in opportunistic screening for colorectal cancer in Chinese population: a meta-analysis
10.3760/cma.j.cn115624-20240104-00010
- VernacularTitle:血清CEA、CA19-9和CA242检测在中国人群结直肠癌机会性筛查中应用的荟萃分析
- Author:
Yu LI
1
;
He TONG
;
Jian YIN
;
Lin HUA
;
Dongning CHEN
;
Kai ZHANG
Author Information
1. 首都医科大学附属北京同仁医院体检科，北京 100730
- Keywords:
Colorectal neoplasms;
Meta-analysis;
Carcinoembryonic antigen;
CA19-9 antigen;
CA242 antigen
- From:
Chinese Journal of Health Management
2024;18(8):601-608
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the application value of serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9 and CA242 in screening colorectal cancer with a meta-analysis.Methods:A literature search was conducted in the databases of Pubmed, Embase, Cochrane, CNKI, Wanfang and VIP to identify studies on applying CEA, CA19-9 and CA242 for detection of colorectal cancer from the establishment of the databases to October 2023. The Quality Evaluation Tool of Diagnostic Accuracy Studies (QUADAS-2) was used to evaluate the quality of the literature. Stata17.0 statistical software was used for meta-analysis. Deeks funnel plot was used to analyze publication bias.Results:A total of 34 articles of case-control studies met the criteria. Meta-analysis revealed that the diagnostic accuracy and sensitivity of CEA, CA19-9 and CA242 were all low, the area under the curve (AUC) of summary receiver operating characteristic curve was 0.62, 0.63 and 0.73, the sensitivity was 0.42, 0.27 and 0.36, respectively. The combined detection of CEA+CA19-9+CA242 significantly improved the pooled diagnostic accuracy (AUC: 0.92(95% CI: 0.89-0.94) and sensitivity: 0.75(95% CI: 0.65-0.83)), the specificity was mildly reduced (dropped from above 0.95 to 0.90(95% CI 0.87-0.93)). The Deek′s test indicated no publication bias. Conclusions:Combined detection of CEA+CA19-9+CA242 can significantly improve the diagnostic accuracy and sensitivity in screening colorectal cancer with a compromised specificity. However, due to the lack of data, whether it can meet the demand for opportunistic screening in the physical examination population needs to be confirmed.
