Yang Ying, Yan Shirong, Tian Hui, Bao Yixi
Department of Laboratory Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China.
Medicine (Baltimore). 2018 Mar;97(9):e9994. doi: 10.1097/MD.0000000000009994.
Because of the high malignant degree of pancreatic cancer (PC), the early diagnosis of PC is of great concern. Macrophage inhibitory cytokine-1 (MIC-1) was reported to be a potential diagnostic biomarker, but its diagnostic value is indeterminate. Therefore, we performed this meta-analysis to compare it to carbohydrate antigen 19-9 (CA19-9), the most frequently used serum biomarker in PC.
After a systematic review of the relevant studies, the pooled diagnostic indices, including sensitivity, specificity, positive/negative likelihood ratio (PLR/NLR), diagnostic odds ratio (DOR), summary receiver operating characteristic curve (sROC), and area under the SROC curve (AUC) were used to evaluate the diagnostic value of MIC-1 and CA19-9 for PC. These indices were pooled with random-effects models. We explored the heterogeneity by meta-regression.
Fourteen studies comprising a total of 2826 subjects were included in our meta-analysis. The summary estimates for MIC-1 and CA19-9 are listed as follows: sensitivity, 80% [95% confidence interval (CI) 78-82] versus 71% (95% CI 68-73); specificity, 85% (95% CI 83-87) versus 88% (95% CI 86-90); DOR, 24.57 (95% CI 14.00-43.10) versus 17.65 (95% CI 11.65-26.76); area under sROC (AUC), 0.8945 versus 0.8322; PLR, 5.18 (95% CI 3.24-8.26) versus 5.34 (95% CI 3.78-7.54); and NLR, 0.23 (95% CI 0.19-0.29) versus 0.32 (95% CI 0.28-0.37).
These data demonstrate that serum MIC-1 has a comparable diagnostic accuracy to CA19-9 for PC.
由于胰腺癌（PC）恶性程度高，其早期诊断备受关注。据报道，巨噬细胞抑制细胞因子-1（MIC-1）是一种潜在的诊断生物标志物，但其诊断价值尚无定论。因此，我们进行了这项荟萃分析，以将其与PC中最常用的血清生物标志物糖类抗原19-9（CA19-9）进行比较。
在对相关研究进行系统回顾后，采用合并诊断指标，包括敏感性、特异性、阳性/阴性似然比（PLR/NLR）、诊断比值比（DOR）、汇总受试者工作特征曲线（sROC）和sROC曲线下面积（AUC），来评估MIC-1和CA19-9对PC的诊断价值。这些指标采用随机效应模型进行合并。我们通过Meta回归探讨异质性。
我们的荟萃分析纳入了14项研究，共2826名受试者。MIC-1和CA19-9的汇总估计值如下：敏感性，80%[95%置信区间（CI）78 - 82]对71%（95%CI 68 - 73）；特异性，85%（95%CI 83 - 87）对88%（95%CI 86 - 90）；DOR，24.57（95%CI 14.00 - 43.10）对17.65（95%CI 11.65 - 26.76）；sROC曲线下面积（AUC），0.8945对0.8322；PLR，5.18（95%CI 3.24 - 8.26）对5.34（95%CI 3.78 - 7.54）；NLR，0.23（95%CI 0.19 - 0.29）对0.32（95%CI 0.28 - 0.37）。
这些数据表明，血清MIC-1对PC的诊断准确性与CA19-9相当。
