Pyo Jung-Soo, Kang Guhyun, Cho Won Jin, Choi Sang Bong
Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea.
Pathol Res Pract. 2016 Aug;212(8):710-6. doi: 10.1016/j.prp.2016.05.006. Epub 2016 May 18.
The aim of this study was to investigate the clinicopathological significance and concordance rate of c-MET immunohistochemistry (IHC) in non-small cell lung cancer (NSCLC) through meta-analysis and diagnostic test accuracy review.
The current study included 4454 NSCLC cases of 22 eligible studies. The meta-analysis examined the correlation between c-MET IHC expression and clinicopathological parameters. We investigated concordance rate between c-MET IHC and genetic alteration and performed subgroup analysis based on c-MET IHC cut-off value.
The estimated positive rate of c-MET IHC was 0.440 (95% confidence interval [CI] 0.355-0.529). The positive rate of c-MET IHC was significantly high in non-squamous cell carcinomas and tumors with stage III-IV. However, there was no significant difference between c-MET IHC positivity and sex, smoking, and lymph node metastasis. The c-MET IHC positivity was significantly correlated with poor overall survival (hazard ratio 1.551, 95% CI 1.101-2.184). In c-MET IHC-positive and negative groups, the concordance rate was 0.941 (95% CI 0.885-0.971) and 0.300 (95% CI 0.196-0.429), respectively. The pooled sensitivity and specificity of the high cut-off subgroup for c-MET IHC was 1.00 (95% CI 0.92-1.00) and 0.78 (95% CI 0.75-0.81), respectively. The diagnostic odds ratio and the area under curve on summary receiver operating characteristic curve were 76.56 (95% CI 8.23-712.41) and 0.9949, respectively.
The c-MET IHC could be useful for screening of c-MET genetic alteration in NSCLC patients. Detailed criteria for c-MET IHC evaluation are necessary to determine how to best apply this approach in daily practice.
本研究旨在通过荟萃分析和诊断试验准确性评估,探讨c-MET免疫组化(IHC)在非小细胞肺癌(NSCLC)中的临床病理意义及一致性率。
本研究纳入了22项符合条件研究中的4454例NSCLC病例。荟萃分析检测了c-MET IHC表达与临床病理参数之间的相关性。我们研究了c-MET IHC与基因改变之间的一致性率,并根据c-MET IHC临界值进行亚组分析。
c-MET IHC的估计阳性率为0.440(95%置信区间[CI]0.355-0.529)。c-MET IHC阳性率在非鳞状细胞癌和III-IV期肿瘤中显著较高。然而,c-MET IHC阳性与性别、吸烟及淋巴结转移之间无显著差异。c-MET IHC阳性与总生存期较差显著相关(风险比1.551,95%CI 1.101-2.184)。在c-MET IHC阳性和阴性组中,一致性率分别为0.941(95%CI 0.885-0.971)和0.300(95%CI 0.196-0.429)。c-MET IHC高临界值亚组的合并敏感性和特异性分别为1.00(95%CI 0.92-1.00)和0.78(95%CI 0.75-0.81)。汇总受试者工作特征曲线的诊断比值比和曲线下面积分别为76.56(95%CI 8.23-712.41)和0.9949。
c-MET IHC可用于筛查NSCLC患者的c-MET基因改变。需要c-MET IHC评估的详细标准来确定如何在日常实践中最佳应用该方法。