Department of General Surgery, Zhejiang Hospital, Hangzhou, Zhejiang, China.
Department of General Surgery, People's Hospital of Anji, Huzhou, Zhejiang, China.
PLoS One. 2018 Nov 20;13(11):e0207039. doi: 10.1371/journal.pone.0207039. eCollection 2018.
Tissue inhibitor of metalloproteinase-1 (TIMP-1) is a glycoprotein involved in cell survival and tumorigenesis. There have been some promising results regarding the diagnostic value of TIMP-1 for patients with colorectal cancer (CRC). The aim of the present study was to assess the diagnostic accuracy and clinical utility of serum TIMP-1 in CRC patients through meta-analysis.
A systematic search of online databases was performed to collect eligible studies. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operator characteristic (SROC) curve were generated from accuracy data using the random-effects model. Fagan's nomogram and the likelihood matrix were applied to estimate the clinical utility of TIMP-1.
A total of 9 eligible studies with 1886 patients were included. Among the patients, 819 were pathologically diagnosed with CRC, whereas 1067 did not have adenomas or other cancers. The overall sensitivity, specificity, and DOR of TIMP-1 for the diagnosis of CRC were 0.65 (95% confidence interval (CI): 0.57-0.72), 0.87 (95% CI: 0.76-0.94), and 12.73 (95% CI 5.71-28.38), respectively. The area under the SROC was 0.77 (95% CI, 0.73-0.81), suggesting the potential diagnostic value of TIMP-1 in CRC patients. Among patients with a pretest CRC probability of 20%, posttest probabilities were 56% and 9% for positive and negative TIMP-1 results, respectively.
TIMP-1 expression exhibits an upper moderate diagnostic value in CRC, and TIMP-1 assessment may be useful as a noninvasive screening tool for CRC in clinical practice.
组织金属蛋白酶抑制剂-1（TIMP-1）是一种参与细胞存活和肿瘤发生的糖蛋白。TIMP-1 对结直肠癌（CRC）患者的诊断价值已有一些有希望的结果。本研究旨在通过荟萃分析评估血清 TIMP-1 在 CRC 患者中的诊断准确性和临床实用性。
通过系统搜索在线数据库，收集合格的研究。使用随机效应模型，从准确性数据中生成汇总敏感性、特异性、诊断比值比（DOR）和汇总受试者工作特征（SROC）曲线。应用 Fagan 的列线图和似然矩阵来估计 TIMP-1 的临床实用性。
共纳入 9 项符合条件的研究，共 1886 例患者。在患者中，819 例经病理诊断为 CRC，1067 例无腺瘤或其他癌症。TIMP-1 对 CRC 的总体诊断敏感性、特异性和 DOR 为 0.65（95%置信区间（CI）：0.57-0.72）、0.87（95% CI：0.76-0.94）和 12.73（95% CI 5.71-28.38）。SROC 的曲线下面积为 0.77（95% CI，0.73-0.81），提示 TIMP-1 在 CRC 患者中有潜在的诊断价值。在术前 CRC 概率为 20%的患者中，TIMP-1 阳性和阴性结果的术后概率分别为 56%和 9%。
TIMP-1 表达在 CRC 中具有中上水平的诊断价值，TIMP-1 评估可能是临床实践中 CRC 非侵入性筛查工具的有用方法。
