Abstract
This study is aimed at determining the best nonacid nucleic blood tumor marker panels in terms of sensitivity, specificity, and accuracy in order to detect breast cancer in early stages (I, II, and III) among eligible women for breast cancer screening. PubMed, Web of Science, Embase, Scopus, and Cochrane were systematically reviewed to assess nonacid nucleic blood tumor marker panels' diagnostic value in women, both healthy and patient (before any anticancer treatment), for detecting breast cancer. A network meta-analysis was carried out using a Bayesian network meta-analysis to estimate combined odd ratio (OR) and 95% CI credible interval for presenting the results. Rankograms plot was drawn to rank the diagnostic value of different panels. Of the 2358 titles initially identified, 9 studies and 8 panels were included in the network meta-analysis. Panels A (MMP-9/TIMP-1) and K (TF1+TF2+TF3) had the highest sensitivity in early stages, as panel A with OR = 11.61 and 95% CI (1.49-102.5) demonstrated a better function than mammography. Panels H (CA 15.3 + IL-18) and A (MMP-9/TIMP-1) had the highest specificity in early stages, but no significant difference with mammography. Panels A (MMP-9/TIMP-1) and H (CA 15.3 + IL-18) had the highest accuracy in early stages, as they significantly exhibited a higher function than mammography with OR = 6.87 and 95% CI (2.07-31.35) as well as OR = 3.44 and 95% CI (1.15-11.07), respectively. Panel A including MMP-9/TIMP-1 in early stages demonstrated a higher diagnostic value for breast cancer than the rest of the panels.
Highlights
The cancer is the second prevalent cause of mortality after cardiovascular diseases in the world and developed countries, and the third cause in developing countries [1]
Based on the European Commission Initiative on Breast Cancer (ECIBC), screening should be followed by regular mammography and in combination with annual MRI for women with familial breast cancer [9]
According to the International Agency for Research on Cancer (IARC), World Health Organization (WHO), and eighth edition of American Joint Committee on Cancer (AJCC), diagnostic work-up for early breast cancer can be divided into four assessments that are as follows: general health status such as history taking, physical examination (CBE and BSE) and full blood count, assessment of primary tumor including physical examination in combination with imaging methods along with core biopsy, examination of regional lymph nodes, and detecting of metastatic disease [9]
Summary
The cancer is the second prevalent cause of mortality after cardiovascular diseases in the world and developed countries, and the third cause in developing countries [1]. Among the different types of cancers, breast cancer includes 23 percent of all the women cancers and is the most prevalent cancer as well as the deadliest malignancy among women. It is the second cause of death which is resulted from the cancer after the lung cancer and one of the most important worryingly causes of women’s health [2–4]. According to the International Agency for Research on Cancer (IARC), World Health Organization (WHO), and eighth edition of American Joint Committee on Cancer (AJCC), diagnostic work-up for early breast cancer can be divided into four assessments that are as follows: general health status such as history taking, physical examination (CBE and BSE) and full blood count, assessment of primary tumor including physical examination in combination with imaging methods along with core biopsy, examination of regional lymph nodes, and detecting of metastatic disease [9]
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