Diagnostic Accuracy of Galectin‐3 for Well‐Differentiated Thyroid Cancer on Fine‐Needle Aspiration: A Meta‐analysis

Abstract

Objectives: (1) Examine and meta-analyze the literature on galectin-3 staining on fine-needle aspiration (FNA) samples of thyroid nodules. (2) Summarize the diagnostic test accuracy of galectin-3 staining on FNA for well-differentiated thyroid cancer (WDTC). Methods: A systematic review of studies from 1990 to 2014 examining the diagnostic test properties of galectin-3 on thyroid nodule samples obtained by FNA with regard to WDTC. Data were meta-analyzed using DerSimonian-Laird random effect models for data pooling. Studies were weighted by inverse variance, and between-study variance was estimated using the Empirical Bayes method. Study heterogeneity and threshold effects were analyzed using the Cochrane Q and Spearman correlation coefficient, respectively. Results: Sixteen studies with 2076 cases were identified. The pooled sensitivity of galectin-3 for WDTC was 89.4% [confidence interval (CI): 87.2-91.4], and specificity was 91.9% (CI: 90.2-93.4). The positive likelihood ratio was 10.05 (CI: 8.24-12.26), and negative likelihood ratio was 0.12 (CI: 0.10-0.15). The diagnostic odds ratio of a positive galectin-3 stain on FNA was 71.3 (CI: 52.7-96.5). The area under the curve for the summary receiver operating characteristics curve (SROC) was 95.3% (standard error: 0.5%). Conclusions: The current study shows galectin-3 staining of preoperative thyroid nodule FNA samples to be a test with strong diagnostic accuracy for WDTC, as seen by its favorable sensitivity, specificity, diagnostic odds ratio, and SROC curve. This supports its role as a useful adjunct in the preoperative workup of thyroid nodules.