Diagnostic and prognostic utilities of humoral fibulin-3 in malignant pleural mesothelioma: Evidence from a meta-analysis
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Dongxu Pei1, Yongwei Li1, Xinwei Liu1, Sha Yan1, Xiaolan Guo1, Xiaona Xu1, Xiaoxia Guo2
1Department of Clinical Laboratory, Henan Province Hospital of TCM, Zhengzhou, Henan, China
2Department of Clinical Laboratory, Anyang Hospital of Traditional Chinese Medicine
Yongwei Li, email: [email protected]
Keywords: fibulin-3, malignant pleural mesothelioma, diagnosis, prognosis, biomarker
Received: September 26, 2016 Accepted: January 08, 2017 Published: January 18, 2017
Fibulin-3 has emerged as a promising novel biomarker in conforming or monitoring malignant pleural mesothelioma (MPM). This study sought to evaluate the diagnostic and prognostic efficacies of humoral fibulin-3 for MPM. Seven eligible publications comprising 468 MPM cases for diagnosis, and 138 for prognosis were identified. Results manifested that humoral fibulin-3 sustained a pooled sensitivity of 0.62 (95% CI: 0.45–0.77) and specificity of 0.82 (95% CI: 0.73–0.89) in discriminating MPM patients from cancer-free individuals, corresponding to an AUC (area under the curve) of 0.81. For the survival analysis, fibulin-3 expression was not markedly associated with overall survival (OS) time of the MPM patients [HR (hazard ratio): 1.84, 95% CI: 0.75–4.56, P = 0.185]. In the subgroup analyses stratified by test matrix and ethnicity, data revealed that serum-based fibulin-3 examination achieved superior accuracy than plasma-based analysis (sensitivity: 0.77 versus 0.54; specificity: 0.85 versus 0.77; AUC: 0.92 versus 0.69); additionally, testing of fibulin-3 in Europeans retained higher efficacy than those in Americans and Australians. Taken together, fibulin-3 confers a relatively high diagnostic efficacy and is acceptable to be an auxiliary biomarker to aid in MPM identification.
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