Department of Clinical Laboratory, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, No.24 Jinghua Road, Jianxi District, Luoyang, 471000, China.
Department of Rehabilitation, Seafarers' General Hospital in Heilongjiang Province, Harbin, 150000, China.
BMC Cancer. 2019 Feb 26;19(1):177. doi: 10.1186/s12885-019-5385-y.
Previous studies have highlighted cytokine growth differentiation factor 15 (GDF-15) as a potential biomarker for digestive system tumors (DST). This study sought to assess the feasibility of using GDF-15 as a diagnostic and prognostic biomarker in DST.
Eligible studies from multiple online databases were reviewed. Meta-analyses of diagnostic parameters were carried out using standard statistical methods. Study-specific hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to estimate the strength of the relationship between GDF-15 levels and clinical prognosis.
We identified 17 eligible studies comprising 3966 patients with DST. The sensitivity, specificity, and area under the curve (AUC) for the discriminative performance of GDF-15 as a diagnostic biomarker were 0.74 (95% CI: 0.68-0.80), 0.83 (95% CI: 0.75-0.89), and 0.84, respectively. Moreover, increased GDF-15 expression levels were markedly associated with unfavorable overall survival (OS) in patients with DST (HR = 2.34, 95% CI: 2.03-2.70, P < 0.001; I = 0.0%) and colorectal cancer (CRC) (HR = 2.27, 95% CI: 1.96-2.63, P < 0.001; I = 0.0%). Stratification by cancer type, test matrix, ethnicity, and cut-off setting also illustrated the robustness of the diagnostic value of GDF-15 in DST.
Collectively, our data suggest that GDF-15 expression level may have value as a diagnostic and prognostic biomarker, independent of other, traditional biomarkers.
先前的研究强调细胞因子生长分化因子 15（GDF-15）是消化系统肿瘤（DST）的潜在生物标志物。本研究旨在评估 GDF-15 作为 DST 诊断和预后生物标志物的可行性。
从多个在线数据库中筛选出合格的研究。使用标准统计方法对诊断参数进行荟萃分析。计算特定于研究的风险比（HR）和 95%置信区间（CI），以评估 GDF-15 水平与临床预后之间的关系强度。
我们确定了 17 项合格的研究，共纳入 3966 例 DST 患者。GDF-15 作为诊断生物标志物的鉴别性能的敏感性、特异性和曲线下面积（AUC）分别为 0.74（95%CI：0.68-0.80）、0.83（95%CI：0.75-0.89）和 0.84。此外，在 DST 患者中，GDF-15 表达水平升高与总体生存（OS）不良显著相关（HR=2.34，95%CI：2.03-2.70，P<0.001；I=0.0%）和结直肠癌（CRC）（HR=2.27，95%CI：1.96-2.63，P<0.001；I=0.0%）。按癌症类型、检测矩阵、种族和截断值设置进行分层，也说明了 GDF-15 在 DST 中的诊断价值的稳健性。
总的来说，我们的数据表明，GDF-15 表达水平可能具有作为诊断和预后生物标志物的价值，独立于其他传统生物标志物。
