Abstract
BackgroundVarious studies assessing the diagnostic value of serum tumor markers in patients with esophageal cancer remain controversial. This study aims to comprehensively and quantitatively summarize the potential diagnostic value of 5 serum tumour markers in esophageal cancer.MethodsWe systematically searched PubMed, Embase, Chinese National Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM), through February 28, 2013, without language restriction. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were pooled separately and compared with overall accuracy measures using diagnostic odds ratios (DORs) and symmetric summary receiver operating characteristic (SROC) curves.ResultsOf 4391 studies initially identified, 44 eligible studies including five tumor markers met the inclusion criteria for the meta-analysis, while meta-analysis could not be conducted for 12 other tumor markers. Approximately 79.55% (35/44) of the included studies were of relatively high quality (QUADAS score≥7). The summary estimates of the positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) for diagnosing EC were as follows: CEA, 5.94/0.76/9.26; Cyfra21-1, 12.110.59/22.27; p53 antibody, 6.71/0.75/9.60; SCC-Ag, 7.66/0.68/12.41; and VEGF-C, 0.74/0.37/8.12. The estimated summary receiver operating characteristic curves showed that the performance of all five tumor markers was reasonable.ConclusionsThe current evidence suggests that CEA, Cyfra21-1, p53, SCC-Ag and VEGF-C have a potential diagnostic value for esophageal carcinoma.
Highlights
During the last several decades, the incidence of esophageal squamous cell carcinoma (ESCC) has been declining [1,2]
The summary estimates of the positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) for diagnosing Esophageal cancer (EC) were as follows: carcinoembryonic antigen (CEA), 5.94/0.76/9.26; Cyfra21-1, 12.110.59/22.27; p53 antibody, 6.71/0.75/ 9.60; squamous cell cancer antigen (SCC-Ag), 7.66/0.68/12.41; and VEGF-C, 0.74/0.37/8.12
The current evidence suggests that CEA, Cyfra21-1, p53, SCC-Ag and VEGF-C have a potential diagnostic value for esophageal carcinoma
Summary
During the last several decades, the incidence of esophageal squamous cell carcinoma (ESCC) has been declining [1,2]. Esophageal cancer (EC) is a highly aggressive malignancy due to rapid progression, late diagnosis, and poor prognosis of survival, making the mortality rate of EC patients similar to the rate of the incidence [8, 9]. Various biochemical markers have been investigated in the diagnosis and follow-up of EC patients, including p53 antibody, carcinoembryonic antigen (CEA), squamous cell cancer antigen (SCC-Ag), cytokeratin 21–1 fragment (CYFRA21-1), and micro-RNA, there remains a great need to comprehensively and quantitatively summarize the potential diagnostic value of serum biomarkers in esophageal cancer. Various studies assessing the diagnostic value of serum tumor markers in patients with esophageal cancer remain controversial. This study aims to comprehensively and quantitatively summarize the potential diagnostic value of 5 serum tumour markers in esophageal cancer.
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