Department of Community Oncology, Sri Shankara Cancer Hospital and Research Centre, Bengaluru, India.
Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, India.
Syst Rev. 2022 Oct 9;11(1):215. doi: 10.1186/s13643-022-02088-y.
The increasing incidence of breast cancer necessitates the need to explore alternate screening strategies that circumvent the setbacks of conventional techniques especially among population that report earlier age at diagnosis. Serum autoantibodies is one such potential area of interest. However, their ubiquitous presence across cancer types limits its applicability to any one specific type of cancer. This review was therefore carried out to explore and consolidate available evidence on autoantibodies for early detection of breast cancer and to identify those that demonstrated a higher sensitivity.
A diagnostic test accuracy (DTA) review was carried out to ascertain serum autoantibodies that could be used for early detection of breast cancer among women. All relevant articles that investigated the role of autoantibodies in early detection of breast cancer were included for the review. MEDLINE, Scopus, ProQuest, Ovid SP, and Cochrane Library were searched extensively for eligible studies. Quality of the included studies was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. RevMan 5.3 was used for exploratory and MetaDTA 2019 for hierarchical analyses. The review helped identify the most frequently investigated autoantibodies and a meta-analysis further consolidated the findings.
A total of 53 articles were included for the final analysis that reported over a 100 autoantibodies that were studied for early detection of breast cancer in women. P53, MUC1, HER2, HSP60, P16, Cyclin B1, and c-Myc were the most frequently investigated autoantibodies. Of these P53, MUC1, HER2, and HSP60 exhibited higher summary sensitivity measures. While the individual pooled sensitivity estimates ranged between 10 and 56%, the panel sensitivity values reported across studies were higher with an estimated range of 60-87%.
Findings from the review indicate a higher sensitivity for an autoantibody panel in comparison to individual assays. A panel comprising of P53, MUC1, HER2, and HSP60 autoantibodies has the potential to be investigated as an early detection biomarker for breast cancer.
乳腺癌发病率不断上升，需要探索替代的筛查策略，以规避传统技术的缺陷，特别是在报告诊断年龄较早的人群中。血清自身抗体就是一个潜在的研究领域。然而，由于其在各种癌症类型中广泛存在，限制了其在任何一种特定类型癌症中的应用。因此，进行了这项综述，以探讨和整合现有关于用于早期检测乳腺癌的自身抗体的证据，并确定那些具有更高敏感性的自身抗体。
进行了一项诊断测试准确性（DTA）综述，以确定可用于女性乳腺癌早期检测的血清自身抗体。纳入了所有研究自身抗体在乳腺癌早期检测中作用的相关文章。广泛检索了 MEDLINE、Scopus、ProQuest、Ovid SP 和 Cochrane Library 以获取符合条件的研究。使用 QUADAS-2 工具评估纳入研究的质量。使用 RevMan 5.3 进行探索性分析，使用 MetaDTA 2019 进行层次分析。该综述有助于确定最常研究的自身抗体，并进一步通过荟萃分析整合研究结果。
最终分析纳入了 53 篇文章，报道了超过 100 种用于女性乳腺癌早期检测的自身抗体。p53、MUC1、HER2、HSP60、p16、Cyclin B1 和 c-Myc 是最常研究的自身抗体。其中 p53、MUC1、HER2 和 HSP60 表现出更高的汇总敏感性测量值。虽然个体汇总敏感性估计值在 10%至 56%之间，但报告的研究间汇总敏感性值更高，估计范围在 60%至 87%之间。
综述结果表明，与单项检测相比，自身抗体组合具有更高的敏感性。由 p53、MUC1、HER2 和 HSP60 自身抗体组成的组合具有作为乳腺癌早期检测生物标志物的潜力。
