Department of Hepatobiliary Surgery, Dalian Municipal Central Hospital, Dalian, China.
China Medical University, Shenyang, China.
Lab Med. 2024 Sep 4;55(5):543-552. doi: 10.1093/labmed/lmae013.
Pancreatic cancer (PC) is usually detected in the advanced stages. Liquid biopsy has become a revolutionary strategy for cancer diagnosis and prognosis prediction. This study aims to investigate the diagnostic and prognostic value of circulating exosomal glypican-1 (GPC-1) in PC.
We systematically searched relevant studies. For diagnostic accuracy, pooled sensitivity and specificity and the area under the summary receiver operating characteristic curve (AUC) were calculated. Regarding prognostic value, hazard ratios (HRs) and 95% CIs for overall survival (OS) were summarized by using a random-effects model.
We found 8 studies that examined the diagnostic value of circulating exosomal GPC-1 in PC, and 3 studies that investigated its prognostic value. Pooled sensitivity and specificity were 0.88 (95% CI, 0.65-0.97) and 0.86 (95% CI, 0.72-0.94). The AUC was 0.93 (95% CI, 0.90-0.95). Prognostic analysis showed that higher levels of circulating exosomal GPC-1 were associated with poorer OS in PC patients, and the combined HR for OS was 4.59 (random-effects model, 95% CI = 1.17-18.03, P = .022). The results of both studies were robust and neither had publication bias.
Circulating exosomal GPC-1 may be used as a diagnostic and prognostic biomarker for PC. However, this result needs to be validated by further research using a larger sample size.
胰腺癌（PC）通常在晚期被发现。液体活检已成为癌症诊断和预后预测的革命性策略。本研究旨在探讨循环外泌体糖蛋白聚糖-1（GPC-1）在 PC 中的诊断和预后价值。
我们系统地搜索了相关研究。对于诊断准确性，计算了汇总敏感性和特异性以及汇总受试者工作特征曲线（AUC）下的面积。关于预后价值，使用随机效应模型总结了总生存期（OS）的风险比（HRs）和 95%置信区间（CI）。
我们发现了 8 项研究检测了循环外泌体 GPC-1 在 PC 中的诊断价值，以及 3 项研究调查了其预后价值。汇总敏感性和特异性分别为 0.88（95%CI，0.65-0.97）和 0.86（95%CI，0.72-0.94）。AUC 为 0.93（95%CI，0.90-0.95）。预后分析表明，循环外泌体 GPC-1 水平较高与 PC 患者的 OS 较差相关，OS 的合并 HR 为 4.59（随机效应模型，95%CI=1.17-18.03，P=0.022）。这两项研究的结果都是稳健的，且都没有发表偏倚。
循环外泌体 GPC-1 可能可作为 PC 的诊断和预后生物标志物。然而，这一结果需要通过使用更大的样本量进行进一步研究来验证。
