Accuracy of Serum Biomarker Panel (GastroPanel®) in the Diagnosis of Atrophic Gastritis of the Corpus. Systematic Review and Meta-analysis.

Abstract

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.