scholarly journals Meta-analysis of the diagnostic performance of serum carbohydrate antigen 19-9 for the detection of gallbladder cancer

2022 ◽  
pp. 172460082110688
Author(s):  
Xiaolei Zhou
Keyword(s):  
Sample Size ◽  
Gallbladder Cancer ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Carbohydrate Antigen ◽  
Lower Sensitivity ◽  
Significant Heterogeneity ◽  
Potential Candidate ◽  
Meta Regression Analysis

Introduction Carbohydrate antigen 19-9 (CA19-9) is a well-studied tumor marker, yet its diagnostic value for gallbladder cancer remains unclear. The present meta-analysis was conducted to validate the role of serum CA19-9 for the detection of gallbladder cancer. Methods A systematic search of digital databases was conducted, complemented by additional hand-searching. Studies that reported serum CA19-9 for the differentiation of gallbladder cancer cases from non-gallbladder cancer controls were considered eligible. Results A total of 27 studies involving 4300 subjects were included. The pooled sensitivity, specificity, and area under the curve in diagnosing gallbladder cancer were 0.70 (95% confidence interval (CI): 0.63–0.76), 0.92 (95% CI: 0.88–0.94), and 0.89 (95% CI: 0.86–0.92), respectively. The pooled positive likelihood rate, negative likelihood rate, and diagnostic odds rate were 8.30 (95% CI: 5.84–11.69), 0.33 (95% CI: 0.27–0.41), and 25.13 (95% CI: 5.83–39.89), respectively. Meta-regression analysis revealed that there was significantly lower sensitivity (0.69, 95% CI: 0.61–0.77) and specificity (0.91, 95% CI: 0.87–0.95) when CA19-9 was used for the differentiation of gallbladder cancer cases from benign biliary diseases. A better specificity of 0.93 (95% CI: 0.90–0.96) was reached in the setting of a sample size ≥100. Conclusions Serum CA19-9 can be a potential candidate marker for the detection of gallbladder cancer, which maintains moderate sensitivity and good specificity. Attention should be paid to the control type and sample size, which may affect its diagnostic accuracy. Also, results should be interpreted with caution due to significant heterogeneity primarily caused by different thresholds between included studies.

scholarly journals Evaluation of alpha-l-fucosidase for the diagnosis of hepatocellular carcinoma based on meta-analysis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Lei Xi ◽  
Chunqing Yang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Receiver Operating Characteristic Curves ◽  
Sensitivity Specificity ◽  
Review Manager

AbstractObjectivesThe main aim of the present study was to assess the diagnostic value of alpha-l-fucosidase (AFU) for hepatocellular carcinoma (HCC).MethodsStudies that explored the diagnostic value of AFU in HCC were searched in EMBASE, SCI, and PUBMED. The sensitivity, specificity, and DOR about the accuracy of serum AFU in the diagnosis of HCC were pooled. The methodological quality of each article was evaluated with QUADAS-2 (quality assessment for studies of diagnostic accuracy 2). Receiver operating characteristic curves (ROC) analysis was performed. Statistical analysis was conducted by using Review Manager 5 and Open Meta-analyst.ResultsEighteen studies were selected in this study. The pooled estimates for AFU vs. α-fetoprotein (AFP) in the diagnosis of HCC in 18 studies were as follows: sensitivity of 0.7352 (0.6827, 0.7818) vs. 0.7501 (0.6725, 0.8144), and specificity of 0.7681 (0.6946, 0.8283) vs. 0.8208 (0.7586, 0.8697), diagnostic odds ratio (DOR) of 7.974(5.302, 11.993) vs. 13.401 (8.359, 21.483), area under the curve (AUC) of 0.7968 vs. 0.8451, respectively.ConclusionsAFU is comparable to AFP for the diagnosis of HCC.

scholarly journals Diagnostic and prognostic value of miRNAs in hepatoblastoma: A systematic review with meta-analysis

2021 ◽  
Author(s):  
Bin Wu ◽  
◽  
Lixia Guo ◽  
Kaikai Zhen ◽  
Chao Sun
Keyword(s):  
Systematic Review ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Prognostic Indicator ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Likelihood Ratios ◽  
Clinical Value ◽  
Diagnostic And Prognostic Value

Review question / Objective: Background and aim: Increasing evidence has revealed the valuable diagnostic and prognostic applications of dysregulated microRNAs (miRNAs) in hepatoblastoma (HB), the most common hepatic malignancy during childhood. However, these results are inconsistent and remain to be elucidated. In the present study, we aimed to systematically compile up-to-date information regarding the clinical value of miRNAs in HB. Methods: Articles concerning the diagnostic and prognostic value of single miRNAs for HB were searched from databases. The sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR), area under the curve (AUC), and hazard ratios (HRs) were separately pooled to explore the diagnostic and prognostic performance of miRNA. Subgroup and meta-regression analyses were further carried out only in the event of heterogeneity. Results: In all, 20 studies, involving 264 HB patients and 206 healthy individuals, met the inclusion criteria in the six included literature articles. For the diagnostic analysis of miRNAs in HB, the pooled SEN and SPE were 0.76 (95% CI: 0.72–0.80) and 0.75 (95% CI: 0.70–0.80), respectively. Moreover, the pooled PLR was 2.79 (95% CI: 2.12–3.66), NLR was 0.34 (95% CI: 0.26–0.45), DOR was 10.24 (95% CI: 6.55–16.00), and AUC was 0.83, indicating that miRNAs had moderate diagnostic value in HB. For the prognostic analysis of miRNAs in HB, the abnormal expressions of miR-21, miR-34a, miR-34b, miR-34c, miR-492, miR-193, miR-222, and miR-224 in patients were confirmed to be associated with a worse prognosis. The pooled HR was 1.74 (95% CI: 1.20–2.29) for overall survival (OS) and 1.74 (95% CI: 1.31–2.18) for event-free survival (EFS), suggesting its potential as a prognostic indicator for HB. Conclusion: To the best of our knowledge, this is the first comprehensive systematic review and meta-analysis that examines the diagnostic and prognostic role of dysregulated miRNAs in HB patients. The combined meta-analysis results supported the previous individual finds that miRNAs might provide a new, noninvasive method for the diagnostic and prognostic analyses ofHB.

scholarly journals Clinically Correlated MicroRNAs in the Diagnosis of Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Min Jiang ◽  
Xuelian Li ◽  
Xiaowei Quan ◽  
Xiaoying Li ◽  
Baosen Zhou
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Small Cell ◽  
Diagnostic Tools ◽  
Small Cell Lung ◽  
Diagnostic Efficacy

(1) Background. Non-small cell lung cancer (NSCLC) has a high mortality rate. MiRNAs have been found to be diagnostic biomarkers for NSCLC. However, controversial results exist. We conducted this meta-analysis to evaluate the diagnostic value of miRNAs for NSCLC.(2) Methods. Databases and reference lists were searched. Pooled sensitivity (SEN), specificity (SPE), and area under the curve (AUC) were applied to examine the general diagnostic efficacy, and subgroup analysis was also performed.(3) Results. Pooled SEN, SPE, and AUC were 85%, 88%, and 0.93, respectively, for 71 studies. Multiple miRNAs (AUC: 0.96) obtained higher diagnostic value than single miRNA (AUC: 0.86), and the same result was found for Caucasian population (AUC: 0.97) when compared with Asian (AUC: 0.91) and Caucasian/African population (AUC: 0.92). MiRNA had higher diagnostic efficacy when participants contained both smokers and nonsmokers (AUC is 0.95 for imbalanced group and 0.91 for balanced group) than when containing only smokers (AUC: 0.90). Meanwhile, AUC was 0.91 for both miR-21 and miR-210.(4) Conclusions. Multiple miRNAs such as miR-21 and miR-210 could be used as diagnostic tools for NSCLC, especially for the Caucasian and nonsmoking NSCLC.

The Performance of CT versus MRI in the Differential Diagnosis of Cerebral Venous Thrombosis

2018 ◽  
Vol 118 (06) ◽  
pp. 1067-1077 ◽  
Author(s):  
Weilin Xu ◽  
Liansheng Gao ◽  
Tao Li ◽  
Neha Ramdoyal ◽  
Jianmin Zhang ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Accuracy ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Significant Heterogeneity ◽  
Summary Receiver Operating Characteristic ◽  
Ct And Mri

Background Cerebral venous thrombosis (CVT) is a rare disease, and with poor prognosis. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly used image modalities for patients with non-specific neurologic symptoms. We present here a meta-analysis to assess the accuracy of CT and MRI in the differential diagnosis of CVT and cerebral venous sinus thrombosis (CVST). Materials and Methods A comprehensive search of the PubMed, EMBASE, Web of Science, Cochrane Database and Chinese Biomedical (CBM) databases was conducted prior to March 20, 2017. In this report, we assess the methodological quality of each article individually and perform a meta-analysis to obtain the summary of the diagnostic accuracy of CT and MRI in correctly identifying CVT and CVST. Results Twenty-four eligible articles comprising 48 studies (4,595 cases) were included. The pooled sensitivity for CT–CVT/CT–CVST groups is 0.79 (95% confidence interval [CI]: 0.76, 0.82)/0.81(95% CI: 0.78, 0.84), and pooled specificity is 0.90 (95% CI: 0.89, 0.91)/0.89 (0.88, 0.91), with an area under the curve (AUC) for the summary receiver operating characteristic (SROC) of 0.9314/0.9161, respectively. No significant heterogeneity and publication bias was observed across each study. For MRI–CVT/MRI–CVST, the pooled sensitivity is 0.82 (95% CI: 0.78, 0.85)/0.80 (95% CI: 0.76, 0.83), and pooled specificity is 0.92 (95% CI: 0.91, 0.94)/0.91(0.89, 0.92), with an AUC for the SROC of 0.9221/0.9273, respectively. Conclusion This meta-analysis indicates that both CT and MRI have a high level of diagnostic accuracy in the differential diagnosis of CVT and CVST, independent of stage, target for analysis or analysis methods. They could be chosen as alternative sub-optimal gold standards for diagnosing CVT and CVST, especially in emergency.

scholarly journals Color Doppler Imaging Analysis of Ocular Blood Flow Velocities in Normal Tension Glaucoma Patients: A Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-24 ◽  
Author(s):  
Shuo Xu ◽  
Shouyue Huang ◽  
Zhongjing Lin ◽  
Wangmin Liu ◽  
Yisheng Zhong
Keyword(s):  
Color Doppler ◽  
Meta Analysis ◽  
Color Doppler Imaging ◽  
Normal Tension Glaucoma ◽  
Diagnostic Value ◽  
Doppler Imaging ◽  
Diagnostic Tools ◽  
Significant Heterogeneity ◽  
Cochrane Central Register ◽  
Ischemic Change

Background. To evaluate the potential diagnostic value of CDI of retrobulbar hemodynamic changes in NTG patients.Methods. Relevant publications which included PSV, EDV, and RI of OA, CRA, NPCA, and TPCA in NTG patients and normal controls measured by CDI were retrieved from the Cochrane Central Register of Controlled Trials, PubMed, the ISI Web of Knowledge, and EMBASE from 1990 to 2014. Subgroup analyses were made based on IOP-lowering medications uses.Result. In OA, there was significant decrease of PSV with moderate heterogeneity (P<0.00001,I2=49%) and significant decrease of EDV with significant heterogeneity (P=0.0005,I2=87%) in NTG patients. In CRA, similar results of PSV (P<0.00001,I2=42%) and EDV (P<0.00001,I2=80%) were detected. Significant decrease of PSV and EDV with significant heterogeneity was also found in both NPCA (P<0.0001,I2=70%;P<0.0001,I2=76%; resp.) and TPCA (P<0.00001,I2=54%;P<0.00001,I2=65%; resp.). Statistically significant increases of RI were found in CRA (P=0.0002,I2=89%) and TPCA (P=0.02,I2=81%) with significant heterogeneities, though RI in OA (P=0.25,I2=94%) and in NPCA (P=0.15,I2=86%) showed no statistical changes with significant heterogeneities.Conclusions. Ischemic change of retrobulbar hemodynamics is one of the important manifestations of NTG. Hemodynamic parameters measured by CDI might be potential diagnostic tools for NTG.

Meta-Analysis of Microarrays: Diagnostic value of microRNA-21 as a Biomarker for Lung Cancer

2015 ◽  
Vol 30 (3) ◽  
pp. 282-285 ◽  
Author(s):  
Xinxin Meng ◽  
Chen Xiao ◽  
Yuguang Zhao ◽  
Lin Jia ◽  
Yang Tang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Sensitivity Analysis ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
P Value ◽  
Significant Heterogeneity ◽  
Lung Cancer Patients ◽  
Potential Biomarker ◽  
Significant Difference

Background: MicroRNA-21 (miR-21) has previously been demonstrated as a potential biomarker in diagnosis of various human tumors. This meta-analysis was performed to evaluate the possibility of miR-21 as a biomarker for early detection of lung cancer. Methods: Relevant lung cancer-related miRNA microarray datasets were collected from the NCBI Gene Expression Omnibus (GEO) database and EBI ArrayExpress database up to February 2014. Quality control of the output data was estimated using Limma package and ExiMiR package in R. Standardized mean difference (SMD) with 95% confidence intervals (CIs) from selected datasets was pooled. Heterogeneity was assessed using Cochran's Q test and the I2 statistic, and a p value <0.0.05 or I2 >50% was defined as significant heterogeneity. Furthermore, sensitivity analysis was conducted to evaluate the stability of the pooled results. Four miRNA datasets (GSE24704, GSE17681, GSE27486 and GSE40738) from blood samples were selected, including 153 lung cancer patients and 109 healthy people. Results: The pooled results generated by random-effects model revealed that no significant difference was observed between case and control groups (SMD = 0.58; 95% CI, −0.04 to 1.19; p = 0.07) with significant heterogeneity (p = 0.0032, I2 = 78.2%; p = 0.06). Sensitivity analysis indicated that the results of the meta-analysis were stable. Conclusions: MiR-21 expression levels in whole blood and peripheral blood cells did not show significant differences between lung cancer patients and healthy controls, and it might be ineffective to measure miR-21 expression to achieve an early diagnosis of lung cancer.

scholarly journals Diagnostic value of endobronchial ultrasound elastography for differentiating benign and malignant hilar and mediastinal lymph nodes: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jiangfeng Wu ◽  
Yue Sun ◽  
Yunlai Wang ◽  
Lijing Ge ◽  
Yun Jin ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymph Nodes ◽  
Sensitivity Specificity

Aims: In the present study, a meta-analysis was performed to evaluate the diagnostic value of endobronchial ultrasound (EBUS) elastography for differentiating benign and malignant hilar and mediastinal lymph nodes (LNs). Material and methods: A comprehensive literature search was carried out through PubMed, Embase, and Cochrane Library. Two authors screened the papers and extracted the data independently and any discrepancies were resolved by discussion. The methodolog-ical quality of each included study was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the curve were calculated to evaluate the value of EBUS elastography for hilar and mediastinal LNs. Results: Seventeen studies with the number of 2307 LNs were included. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of hilar and mediastinal LNs by EBUS elastography were 0.90 (95% confidence interval [CI], 0.84-0.94), 0.78 (95% CI, 0.74-0.81), 4.1 (95% CI, 3.4-4.9), 0.12 (95% CI, 0.07-0.21) and 33 (95% CI, 17-64), respectively. Furthermore, area under the curve was calculated to be 0.86 (95% CI, 0.82-0.88). Conclusion: EBUS elastography is a valuable technology in the differentiation of benign and malignant hilar and mediastinal LNs and could provide supplementary diagnostic information during endobronchial ultrasound-guided transbronchial needle aspiration. The combination of EBUS elastography and B-mode EBUS could improve the diagnostic accuracy for hilar and mediastinal LNs.

scholarly journals Prognostic and diagnostic value of circRNA expression in colorectal carcinoma: a meta-analysis

2020 ◽  
Author(s):  
Jinpeng Yuan ◽  
Dongming Guo ◽  
Xinxin Li ◽  
Juntian Chen
Keyword(s):  
Colorectal Cancer ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Circular Rnas ◽  
Control Factors ◽  
Potential Biomarker ◽  
Negative Effect ◽  
Newcastle Ottawa Scale

Abstract Background: Circular RNAs (circRNAs) are new stars in the network of noncoding RNAs and are regarded as key control factors in numerous tumours. The purpose of our study was to evaluate the clinical, prognostic and diagnostic role of circRNAs in colorectal cancer. The quality of all the articles were assessed by the Newcastle‐Ottawa Scale. Methods: An online search in electronic databases, including the PubMed, Cochrane Library and Web of Science online databases, was conducted to identify as many relevant papers as possible. Nineteen relevant studies were enrolled in this meta-analysis, with seven on diagnosis, eight on prognosis and 11 on clinicopathological features. Results: For the diagnostic value of circRNAs, the pooled results showed that the area under the curve (AUC) was 0.82 for identifying patients with colorectal cancer, with a sensitivity of 83% and a specificity of 72%. In terms of prognosis, carcinogenic circRNAs have a negative effect on overall survival (OS: HR = 2.29, 95% CI: 1.50-3.52), and increases in tumour suppressor circRNA expression are associated with longer survival (OS: HR = 0.37, 95% CI: 0.22-0.64). And the elevated expression of oncogenic circRNAs is associated with poor clinical features while tumor suppressor circRNAs are the complete opposite. Conclusions: These results suggest that circRNAs may be a potential biomarker for the diagnosis and prognosis of colorectal cancer.

scholarly journals Diagnostic Value of Circulating microRNAs in Laryngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Danni Cheng ◽  
Wendu Pang ◽  
Ke Qiu ◽  
Wenjie Yang ◽  
Yufang Rao ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Laryngeal Squamous Cell Carcinoma ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Circulating Micrornas ◽  
Sensitivity Specificity

Abstract Background : Circulating microRNAs (miRNAs) play an important role in the biological processes of cancers and are promising biomarkers of cancer diagnosis. Objectives : To estimate the diagnostic value of microRNAs in laryngeal squamous cell carcinoma (LSCC) patients, comparing with the non-LSCC controls. Population : Six eligible LSCC studies including 1,585 LSCC patients with corresponding 2,095 non-LSCC controls from years 2000 to 2017 were analyzed. Methods : Medline, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, EMBASE, Cochrane Library and Web of Science were searched in this study. We conducted a meta-analysis to identify studies that reported the diagnostic data of miRNAs both in LSCC patients and controls. I n addition, we evaluated and compared the diagnostic value of upregulated miRNAs with downregulated miRNAs . Results : Six studies with corresponding specificity and sensitivity data were included in this study. The pooled sensitivity, specificity and AUC were 0.89 (95% CI: 0.79-0.94), 0.87 (95% CI: 0.77-0.93), and 0.94 (95% CI: 0.92-0.96), respectively. However, the heterogeneities of these studies were quite high, the value of I 2 for the pooled sensitivity, specificity were 96.82% and 97.08%, respectively. Subgroup analysis of upregulated and downregulated miRNAs showed a similar diagnostic value but the heterogeneity remained high. Publication bias was found in Funnel plot of pooled and upregulated miRNAs, while not obvious in downregulated miRNAs. Conclusions : Circulating miRNAs showed diagnostic significance in laryngeal cancer, however, the results of this meta-analysis revealed significant heterogeneity. Therefore, the diagnostic value of miRNAs in LSCC seems limited.

scholarly journals Mortality Associated With Acute Respiratory Distress Syndrome 2009-2019: A Systematic Review and Meta-regression 

2020 ◽  
Author(s):  
Divyajot Sadana ◽  
Simrat Kaur ◽  
Kesavan Sankaramangalam ◽  
Kinjal Banerjee ◽  
Matthew Siuba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
2009 H1n1 ◽  
Meta Regression ◽  
Meta Regression Analysis

Abstract Background: Acute respiratory distress syndrome (ARDS) is a common occurrence in an intensive care unit. The reported mortality in studies evaluating acute respiratory distress syndrome is highly variable. The adherence to ventilatory specific and adjunctive therapies is also highly variable. We investigated the mortality of ARDS since the 2009 H1N1 pandemic and examined the adherence to ventilatory specific and adjunctive therapies.Methods: We performed a systematic search in MEDLINE and EMBASE using a highly sensitive criterion from January 2009 to May 2019. We then ran a proportional meta-analysis for mortality and a meta-regression analysis using certain variables to address heterogeneity. Results: We screened 5361 citations, of which 85 fully met inclusion criteria. The weighted pooled mortality of all 85 studies published from 2009 to 2019 was 38% (95% CI 35,40). Mortality was higher in observational studies [40% (95% CI 37, 42)] compared to RCTs [35% (95% CI 30,39)], (p=0.04) Significant variability exists in literature of reported tidal volumes, positive end expiratory pressures, plateau pressures, and use adjunctive therapies. The tidal volumes in our systematic review ranged from 5.8 to 8.9 ml/kg with a mean of 7.2 ml/kg. PEEP ranged from 4.6 to 16.1 cm H2O at the time of enrollment with a mean of 10.2 cm H2O. Reported plateau pressures ranged from 21.0 to 35.1 cm H2O, with a mean of 25.6 cm H2O. Higher reported initial PaO2/FiO2 ratios were associated with decreased mortality. A trend towards decreased mortality was seen with lower reported tidal volumes in the included studies.Conclusions: Over the last decade, the mortality in ARDS has marginally improved and there exists significant heterogeneity in the utilization of low tidal volume strategies, application of PEEP and the adoption of adjunctive therapies in the management of these patients in published literature.

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