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Meta-Analysis
. 2015 Feb 18;10(2):e0116951.
doi: 10.1371/journal.pone.0116951. eCollection 2015.

Diagnostic value of multiple tumor markers for patients with esophageal carcinoma

Jun Zhang  1 , Zhenli Zhu  1 , Yan Liu  1 , Xueyuan Jin  2 , Zhiwei Xu  3 , Qiuyan Yu  1 , Ke Li  1
Affiliations
Meta-Analysis

Diagnostic value of multiple tumor markers for patients with esophageal carcinoma

Jun Zhang et al. PLoS One. .

Abstract

Background: 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.

Methods: We 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.

Results: Of 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.

Conclusions: The current evidence suggests that CEA, Cyfra21-1, p53, SCC-Ag and VEGF-C have a potential diagnostic value for esophageal carcinoma.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of study selection by using electronic database searches.
Fig 2
Fig 2. Forest plot of estimates of the diagnostic odds ratio (DOR) for CEA, Cyfra21–1, p53, and SCC-Ag in the diagnosis of EC.
Point estimates of the diagnostic odds ratio from each study are shown as solid circles. Error bars are 95% confidence intervals.
Fig 3
Fig 3. Funnel plot for the assessment of potential bias in CEA, Cyfra21–1, p53 and SCC-Ag assays.
The funnel graph plots the DOR (diagnostic odds ratio) against the 1/root (effective sample size), the dotted line is the regression line.
See this image and copyright information in PMC

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