Serum CA72-4 as a Biomarker in the Diagnosis of Colorectal Cancer: A Meta-analysis

Abstract

The purpose of this meta-analysis was to investigate the serum CA72-4 as a biomarker in the diagnosis of colorectal cancer by pooling the open published data.

Methods: An electronic search of databases Pubmed, Medline, Web of Science, Cochrane Embase CBM, and CNKI were performed by two reviewers (Han Yanqing, Dong Cheng) independently to identify the studies relevant to serum CA72-4 as a biomarker in the diagnosis of colorectal cancer. The patient number of true positive(tp), false positive(fp), false negative(fn) and true negative(tn) were extracted from each included study. The diagnostic performance of serum CA72-4 as a biomarker in the diagnosis of colorectal cancer was assessed by pooled sensitivity, specificity and hierarchical summary receiver operating characteristic curve (HSROC). All the data was pooled by MetaDiSc 1.4 and Stata/SE 11.0 statistical software. Results A total of 22 studies with 2474 colorectal patients and 1576 controls were included in the present study and meta-analysis. The combined diagnostic sensitivity and specificity were 0.50 (95%CI:0.48-0.52) and 0.86 (95%CI:0.84-0.88) for serum CA72-4 as a biomarker in the diagnosis of colorectal cancer. The pooled positive and negative likelihood ratio were 3.41(95%CI:2.57-4.53) and 0.62(0.55-0.71). The pooled area under the ROC curve (AUC) was 0.73. Deeks'funnel plot and Egger's line regression test (p=0.49) showed no significant publication bias in the present meta-analysis. Conclusion Due toits low diagnostic sensitivity, the diagnostic performance of serum CA72-4 as a biomarker for colorectal cancer screening is limited.

Keywords: Biomarker; CA72-4; Colorectal cancer; Diagnosis; Meta-analysis.

Figure 1

The publication searching flow chart

Figure 2

The methodological quality summary for each included study. (The authors’judgments for each risk of bias item. + is “low risk”; - is “high risk’’; ?is“moderate risk”).

Figure 3

The diagnostic sensitivity of serum CA72-4 in the diagnosis of colorectal cancer

Figure 4

The diagnostic specificity of serum CA72-4 in the diagnosis of colorectal cancer

Figure 5

Combined positive likelihoodratio(Positive LR) for serum CA72-4 in the diagnosis of colorectal cancer

Figure 6

Combined negative likelihoodratio(negative LR) for serum CA72-4 in the diagnosis of colorectal cancer

Figure 7

Combined DOR for serum CA72-4 in the diagnosis of colorectal cancer

Figure 8

The pooled HSROC for serum CA72-4 in the diagnosis of colorectal cancer

Figure 9

Deeks’funnel plot for evaluation of the publication bias