Abstract
To evaluate the dependability and accuracy of midkine (MK) in the diagnosis of hepatocellular carcinoma (HCC). PubMed, EMBASE, Web of Science, China Biology Medicine disc and grey literature sources were searched from the date of database inception to January 2019. Two authors (B-H.Z. and B.L.) independently extracted the data and evaluated the study quality using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were estimated using a bivariate model. Moreover, hierarchical summary receiver operating characteristic curves were generated. The diagnostic odds ratio (DOR) and area under the curve (AUC) were pooled using a univariate model. Nine articles (11 studies) were included (1941 participants). The bivariate analysis revealed that the sensitivity and specificity of MK for HCC diagnosis were 0.85 (95% CI 0.78-0.91) and 0.83 (95% CI 0.76-0.88), respectively. We also found a LR+ of 5.05 (95% CI 3.33-7.40), a LR- of 0.18 (95% CI 0.11-0.28), a DOR of 31.74 (95% CI 13.98-72.09) and an AUC of 0.91 (95% CI 0.84-0.99). Subgroup analyses showed that MK provided the best efficiency for HCC diagnosis when the cutoff value was greater than 0.5 ng/mL. MK has an excellent diagnostic value for hepatocellular carcinoma.
Highlights
According to recent EASL HCC guidelines, approximately 854,000 new cases of liver cancer are diagnosed annually, among which hepatocellular carcinoma (HCC) is the most frequent type, accounting for up to 90 percent [1]
The bivariate analysis revealed that the sensitivity and specificity of MK for HCC diagnosis were 0.85 and 0.83, respectively
We found a LR+ of 5.05, a LR− of 0.18, a diagnostic odds ratio (DOR) of 31.74 and an area under the curve (AUC) of 0.91
Summary
According to recent EASL HCC guidelines, approximately 854,000 new cases of liver cancer are diagnosed annually, among which hepatocellular carcinoma (HCC) is the most frequent type, accounting for up to 90 percent [1]. Patients who are diagnosed with HCC at an inchoate stage are more likely to be cured and have a 70% chance of living more than 5 years with the appropriate therapies such as hepatectomy or liver transplantation Those who are diagnosed at an advanced stage, in contrast, qualify only for palliative treatments and have unsatisfactory median survival times ranging from 1 to 2 years [5]. These data corroborate the importance of early and accurate HCC diagnosis
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