Abstract
The diagnostic value of serum HE4 in patients with lung cancer remains controversial. Thus, we performed a systematic review and meta-analysis to assess the diagnostic accuracy of serum HE4 for lung cancer. We conducted a comprehensive literature search in PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), and WANFANG databases between Jan. 1966 and Nov. 2014. The diagnostic sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and summary receiver operating characteristic curve (SROC) were pooled by Meta-DiSc 1.4 software. A total of seven articles including 715 cases and 549 controls were included for analysis. The summary estimates for serum HE4 in the diagnosis of lung cancer in these studies were pooled SEN 0.72 (95% CI: 0.68–0.75), SPE 0.85 (95% CI: 0.81–0.88), PLR 4.68 (95% CI: 3.23–6.78), NLR 0.31 (95% CI: 0.24–0.39), and DOR 17.14 (95% CI: 9.72–30.20), and the area under the curve (AUC) was 0.8557. This meta-analysis indicated that serum HE4 is a potential tool in the diagnosis of lung cancer. In addition, considering the high heterogeneity and potential publication bias, further studies with rigorous design and large sample size are needed in the future.
Highlights
Lung cancer is a leading cause of cancer morbidity and mortality worldwide
Lines of evidence demonstrated that serum carcinoembryonic antigen (CEA), neuron specific enolase (NSE), cytokeratin fragment (CYFRA21-1), tissue polypeptide specific antigen (TPS), and progastrin-releasing peptide (ProGRP) were believed as potential markers to diagnosis of lung cancer [5,6,7,8,9,10]
The PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), and WANFANG databases were searched for articles that were published between Jan. 1966 and Nov. 2014
Summary
Lung cancer is a leading cause of cancer morbidity and mortality worldwide. According to statistics from the National Office of Tumor Cure and Prevention, about 600,000 people die of lung cancer each year in China, accounting for approximately 20% of all cancer deaths [1, 2]. Despite advances in the diagnosis and treatment of lung cancer, the prognosis of lung cancer is still poor, with around 16% surviving 5 years after diagnosis [3]. Considering that the 5-year survival of stage I in lung cancer is as high as 83% [4], early diagnosis is essential to reduce mortality of this fatal disease. To date, circulating tumor markers for lung cancer have become a major focus. Lines of evidence demonstrated that serum carcinoembryonic antigen (CEA), neuron specific enolase (NSE), cytokeratin fragment (CYFRA21-1), tissue polypeptide specific antigen (TPS), and progastrin-releasing peptide (ProGRP) were believed as potential markers to diagnosis of lung cancer [5,6,7,8,9,10]. Early and accurate diagnostic tool for lung cancer is especially important for lung cancer management
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