Diagnostic accuracy of PCR for detecting ALK gene rearrangement in NSCLC patients: A systematic review and meta-analysis
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Xia Zhang1,*, Jian-Guo Zhou2,*, Hua-Lian Wu1, Hu Ma2 and Zhi-Xia Jiang1
1Department of Nursing, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China
2Department of Oncology, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China
*These authors contributed equally to this work
Hu Ma, email: [email protected]
Zhi-Xia Jiang, email: [email protected]
Keywords: polymerase chain reaction, anaplastic lymphoma kinase, carcinoma, non-small cell lung, systematic review
Received: November 25, 2015 Accepted: March 28, 2017 Published: May 17, 2017
Background: Anaplastic lymphoma kinase (ALK) gene fusion has been reported in 3~5% non-small cell lung carcinoma (NSCLC) patients, and polymerase chain reaction (PCR) is commonly used to detecting the gene status, but the diagnostic capacity of it is still controversial. A systematic review and meta-analysis was conducted to clarify the diagnostic accuracy of PCR for detecting ALK gene rearrangement in NSCLC patients.
Results: 18 articles were enrolled, which included 21 studies, involving 2800 samples from NSCLC patients. The overall pooled parameters were calculated: sensitivity was 92.4% [95% confidence interval (CI): 82.2%–97.0%], specificity was 97.8% [95% CI: 95.1%–99.0%], PLR was 41.51 [95% CI: 18.10–95.22], NLR was 0.08 [95% CI: 0.03–0.19], DOR was 535.72 [95% CI: 128.48–2233.79], AUROC was 0.99 [95% CI: 0.98–1.00].
Materials and Methods: Relevant articles were searched from PubMed, EMBASE, Web of Science, Cochrane library, American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), China National Knowledge Infrastructure (CNKI), China Wan Fang databases and Chinese biomedical literature database (CBM). Diagnostic capacity of PCR test was assessed by the pooled sensitivity and specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under the summary receiver operating characteristic (AUROC).
Conclusions: Based on the results from this review, PCR has good diagnostic performance for detecting the ALK gene fusion in NSCLC patients. Moreover, due to the poor methodology quality of the enrolled trials, more well-designed multi-center trials should be performed.
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