Wiyarta Elvan, Nugraha Darrin Ananda, Ramadani Muhammad Indera, Gustya Gita Fajri, Ammar Muhammad Farrasy, Edwar Hana Dzakira, Kheirizzad Nildza, Mukhlisah Mutiah Nurul, Burhan Erlina, Syahruddin Elisna
Respiratory and Tuberculosis Research and Training Center (SATURATE), Faculty of Medicine, Persahabatan National Hospital, Universitas Indonesia, Jakarta, Indonesia.
Infection Division, Department of Pulmonology, Faculty of Medicine, Universitas Indonesia, Persahabatan National Hospital, Jakarta, Indonesia.
Front Oncol. 2023 Jul 26;13:1201713. doi: 10.3389/fonc.2023.1201713. eCollection 2023.
The review addresses the knowledge gap concerning the diagnostic value and clinical utility of tumor-educated platelets (TEPs) in adult patients with lung cancer.
We searched twelve databases: PubMed, CENTRAL, EMBASE, CINAHL, MEDLINE, Scopus, ProQuest, MedRxiv, BioRxiv, SSRN, Clinicaltrials.gov, and CNKI up to 24 March 2023, to include any diagnostic study regarding TEPs and LC. TEPs diagnostic value was evaluated from pooled sensitivity and specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC). QUADAS 2 was used to assess the risk of bias. Heterogeneity analysis was assessed using the receiver operating characteristic (ROC) plane, Galbraith plot, bivariate boxplot, sensitivity analysis, and meta-regression. TEPs clinical utility was evaluated from Fagan's nomogram.
44 reports from 10 studies, including 7,858 events and 6,632 controls, were analyzed. The pooled sensitivity, specificity, PLR, NLR, and DOR were 0.80 (95% CI 0.79-0.80), 0.69 (95% CI 0.69-0.70), 2.92 (95% CI 2.50-3.41), 0.26 (95% CI 0.21-0.32), and 12.1 (95% CI 8.61-16.76), respectively. In addition, the AUC of the Summary ROC curve was 0.85 (95% CI: 0.81-0.88). The overall risk of bias was low. Heterogeneity may result from cancer stage, cancer control, measuring equipment, and RNA types across studies. There was no apparent publication bias (p=0.29) with significant positive (79%) and negative (22%) post-test probability, according to Deeks funnel plot asymmetry test and Fagan's nomogram.
TEPs could be a moderately effective candidate biomarker for LC diagnosis.
本综述探讨了肿瘤诱导血小板（TEP）在成年肺癌患者中的诊断价值和临床应用方面的知识空白。
我们检索了12个数据库：截至2023年3月24日的PubMed、CENTRAL、EMBASE、CINAHL、MEDLINE、Scopus、ProQuest、MedRxiv、BioRxiv、SSRN、Clinicaltrials.gov和CNKI，以纳入任何关于TEP和肺癌的诊断研究。通过合并敏感性和特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）和曲线下面积（AUC）来评估TEP的诊断价值。使用QUADAS 2评估偏倚风险。使用受试者工作特征（ROC）平面、Galbraith图、双变量箱线图、敏感性分析和meta回归评估异质性分析。通过Fagan列线图评估TEP的临床应用。
分析了来自10项研究的44份报告，包括7858例事件和6632例对照。合并敏感性、特异性、PLR、NLR和DOR分别为0.80（95%CI 0.79 - 0.80）、0.69（95%CI 0.69 - 0.70）、2.92（95%CI 2.50 - 3.41）、0.26（95%CI 0.21 - 0.32）和12.1（95%CI 8.61 - 16.76）。此外，汇总ROC曲线的AUC为0.85（95%CI：0.81 - 0.88）。总体偏倚风险较低。异质性可能源于研究中的癌症分期、癌症对照、测量设备和RNA类型。根据Deeks漏斗图不对称性检验和Fagan列线图，没有明显的发表偏倚（p = 0.29），检验后概率显著为正（79%）和负（22%）。
TEP可能是肺癌诊断的一种中等有效的候选生物标志物。
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