SMW Consultants, Ltd, Kaarina, Finland;
Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP, Brazil.
Anticancer Res. 2022 Apr;42(4):1679-1696. doi: 10.21873/anticanres.15645.
BACKGROUND/AIM: The serological biomarker panel (GastroPanel)(GP) developed by Biohit Oyj (Helsinki, Finland) has gained increasing global acceptance in the diagnosis of atrophic gastritis (AG). This is a systematic review and meta-analysis of the studies on diagnostic accuracy of GP (GPA).
Core electronic databases were searched until the end of December 2021, following the principles of the PRISMA-P and using the QUADAS-2 quality assessment tool. STATA software with relevant packages (metandi, midas, mylabels) was used for meta-analysis, with AG of the corpus (AGC) as the endpoint. Summary estimates of Se and Sp, LR+ and LR- were calculated using random effect bivariate model (Forest plots), and summary receiver operating characteristic (SROC) curves by hierarchical SROC (HSROC) model.
Altogether, 49 studies were found eligible, comprising 22,597 patients examined by the GP test. Significant heterogeneity across the studies was confirmed in Forest plots, HSROC and bivariate boxplot. The pooled Se of GP in diagnosis of AGC was 0.70 (95%CI=0.64-0.76) and pooled Sp was 0.93 (95%CI=0.90-0.95), with AUC=0.900 (95%CI=0.170-1.000) in HSROC. In Fagan's nomogram, positive GP test predicts AGC at population level with the likelihood of 72%. Meta-regression and subgroup meta-analysis disclosed publication year (<2008>) as the only significant source of heterogeneity, geographic origin of the study being of borderline significance.
These meta-analytical results confirm the accuracy of GastroPanel test in the diagnosis of AGC, advocating its applicability i) in screening for gastric cancer risk conditions (AG, Helicobacter pylori), as well as ii) in non-invasive diagnosis of dyspeptic patients, and iii) in follow-up of AG-patients.
背景/目的：由芬兰赫尔辛基的 Biohit Oyj 开发的血清生物标志物检测试剂盒（GastroPanel）（GP）在萎缩性胃炎（AG）的诊断中得到了越来越多的全球认可。这是一项关于 GP（GPA）诊断准确性的系统评价和荟萃分析。
根据 PRISMA-P 原则并使用 QUADAS-2 质量评估工具，检索核心电子数据库，直至 2021 年 12 月底。使用 STATA 软件和相关软件包（metandi、midas、mylabel）进行荟萃分析，以胃体萎缩（AGC）为终点。使用随机效应双变量模型（森林图）计算 Se 和 Sp、LR+和 LR-的综合估计值，并使用分层 SROC（HSROC）模型绘制综合接收者操作特征（SROC）曲线。
共发现 49 项符合条件的研究，共纳入 22597 例接受 GP 检测的患者。森林图、HSROC 和双变量箱线图均证实研究间存在显著异质性。GP 诊断 AGC 的汇总 Se 为 0.70（95%CI=0.64-0.76），汇总 Sp 为 0.93（95%CI=0.90-0.95），HSROC 中的 AUC 为 0.900（95%CI=0.170-1.000）。在 Fagan 的列线图中，阳性 GP 检测在人群水平上预测 AGC 的可能性为 72%。元回归和亚组荟萃分析显示，发表年份（<2008 年）是唯一显著的异质性来源，研究的地理来源具有边缘显著性。
这些荟萃分析结果证实了 GastroPanel 检测在 AGC 诊断中的准确性，支持其在以下方面的应用：i）筛查胃癌风险条件（AG、幽门螺杆菌），ii）非侵入性诊断消化不良患者，以及 iii）AG 患者的随访。
