Gong Xiaowen, Xuan Yuerong, Pang Chengshuai, Dong Chenyang, Cao Rui, Wei Zhigang, Liang Chaojie
Department of Biliary and Pancreatic Surgery, First Hospital of Shanxi Medical University, 85(th) Jiefangnan Road, Yingze District, Taiyuan, Shanxi 030001, China.
Clin Chim Acta. 2025 Feb 1;567:120080. doi: 10.1016/j.cca.2024.120080. Epub 2024 Dec 7.
Pancreatic cancer (PC) is a highly aggressive malignancy with poor prognosis and high mortality rate. Identifying reliable biomarkers for the early diagnosis and treatment is urgently needed. This study aims to comprehensively evaluate the diagnostic and prognostic value of DUPAN-2 in PC through a meta-analysis.
We systematically searched PubMed, Embase, and other databases for studies related to DUPAN-2 and its prognostic and diagnostic relevance in PC, covering publications up to August 2024. We used pooled hazard ratios (HRs) to evaluate the prognostic value of DUPAN-2 in PC, the summary receiver operating characteristic (SROC) curve and the area under the curve (AUC) to assess diagnostic performance, while pooled odds ratios (ORs) analyzed associations with clinicopathological features.
A total of 22 studies involving 4765 patients were included in this meta-analysis, with 11 studies focusing on diagnostic analysis, 10 on prognostic analysis, and 3 on clinicopathological features. The diagnostic meta-analysis revealed a pooled sensitivity of 0.63 (95 % CI: 0.56-0.69), a pooled specificity of 0.98 (95 % CI: 0.95-0.99), and an AUC of 0.83 (95 % CI: 0.79-0.86). Subgroup analysis indicated that a DUPAN-2 threshold at 150 U/mL achieved the highest diagnostic performance. The prognostic meta-analysis demonstrated that elevated DUPAN-2 levels were associated with poorer OS (HR = 1.70, 95 % CI: 1.36-2.14) and PFS (HR = 1.33, 95 % CI: 1.14-1.56). Additionally, the clinicopathological features meta-analysis showed that elevated DUPAN-2 levels were associated with vascular invasion (OR = 3.48, 95 % CI: 1.26-9.59), while normalized DUPAN-2 levels were associated with higher resectability (OR = 0.57, 95 % CI: 0.36-0.90) and lower N-stage (OR = 0.39, 95 % CI: 0.24-0.63) CONCLUSION: Serum DUPAN-2 demonstrates significant potential as a biomarker for diagnosis and prognosis in patients with PC.
胰腺癌（PC）是一种侵袭性很强的恶性肿瘤，预后差、死亡率高。迫切需要找到可靠的生物标志物用于早期诊断和治疗。本研究旨在通过荟萃分析全面评估DUPAN-2在PC中的诊断和预后价值。
我们系统检索了PubMed、Embase及其他数据库中与DUPAN-2及其在PC中的预后和诊断相关性相关的研究，涵盖截至2024年8月的出版物。我们使用合并风险比（HR）评估DUPAN-2在PC中的预后价值，汇总受试者工作特征（SROC）曲线和曲线下面积（AUC）评估诊断性能，同时用合并比值比（OR）分析与临床病理特征的关联。
本荟萃分析共纳入22项研究，涉及4765例患者，其中11项研究聚焦诊断分析，10项聚焦预后分析，3项聚焦临床病理特征。诊断性荟萃分析显示合并敏感度为0.63（95%CI：0.56-0.69），合并特异度为0.98（95%CI：0.95-0.99），AUC为0.83（95%CI：0.79-0.86）。亚组分析表明，DUPAN-2阈值为150 U/mL时诊断性能最佳。预后性荟萃分析表明，DUPAN-2水平升高与较差的总生存期（OS）（HR = 1.70，95%CI：1.36-2.14）和无进展生存期（PFS）（HR = 1.33，95%CI：1.14-1.56）相关。此外，临床病理特征荟萃分析显示，DUPAN-2水平升高与血管侵犯相关（OR = 3.48，95%CI：1.26-9.59），而DUPAN-2水平正常化与更高的可切除性（OR = 0.57，95%CI：0.36-0.90）和更低的N分期（OR = 0.39，95%CI：0.24-0.63）相关。结论：血清DUPAN-2作为PC患者诊断和预后的生物标志物具有显著潜力。
