Urinary Angiogenin as a Marker for Bladder Cancer: A Meta-Analysis

Abstract

Aims: Bladder cancer (BCa) is a common cancer in North America and Europe that carries considerable morbidity and mortality. A reliable biomarker for early detection of the bladder is crucial for improving the prognosis of BCA. In this meta-analysis, we examine the diagnostic role of the angiogenin (ANG) protein in patients' urine with bladder neoplasm.

Methods: We performed a systematic literature search using ScienceDirect, Web of Science, PubMed/MEDLINE, Scopus, Google Scholar, and Embase, up to 10^th October 2020 databases. Meta-Disc V.1.4 and Comprehensive Meta-Analysis V.2.2 software calculated the pooled specificity, sensitivity, area under the curve (AUC), diagnostic odds ratio (DOR), positive likelihood ratio (LR⁺), negative likelihood ratio (LR^-), Q ^∗ index, and summary receiver-operating characteristic (SROC) for the role of ANG as a urinary biomarker for BCa patients.

Results: Four case-control studies were included with 656 participants (417 cases and 239 controls) in this meta-analysis. The pooled sensitivity of 0.71 (95% CI: 0.66-0.75), specificity of 0.78 (95% CI: 0.73-0.81), LR⁺ of 3.34 (95% CI: 2.02-5.53), LR^- of 0.37 (95% CI: 0.32-0.44), DOR of 9.99 (95% CI: 4.69-21.28), and AUC of 0.789 and Q ^∗ index of 0.726 demonstrate acceptable diagnostic precision of ANG in identifying BCa.

Conclusion: This meta-analysis showed that ANG could be a fair biomarker for the diagnosis of BCa patients.

Figure 1

Flow chart of the study selection.

Figure 2

The sensitivity (a), specificity (b), LR⁺ (c), LR⁻ (d), and DOR (e) forest plots for the diagnosing role of ANG in the bladder carcinoma patients based on the random effects model.

Figure 3

The ROC plane curve (a) and SROC (b) for diagnosing the role of ANG in the bladder carcinoma patients based on the random effects model.

Figure 4

The diagnostic odds ratio based on the fixed effects model meta-analysis performed with CMA software.