Objective To evaluate diagnostic value of tumor marker — the serum neuron specific enolase (NSE) in patients with suspected small cell lung cancer with lung pathological diagnosis as the gold standard.
Methods A search in The Cochrane Library, PubMed, OVID, MEDLINE, EMbase, Cancerlit, China National Knowledge Infrastructure (CNKI), and CBM, was conducted from 1966 to 2008. Hand searches and additional searches were also conducted. Criteria for inclusion were established based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests. Subsequently, the characteristics of the included articles were appraised and extracted. Statistical analysis was performed employing Revman 4.2 software. Heterogeneity of the included articles was tested, which was used to select the proper effect model to calculate pooled weighted sensitivity and specificity. The Summary Receiver Operating Characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally, sensitivity analysis was performed.
Results Six articles entered this meta-analysis: four English articles, one Japanese article and one Chinese article. The quality level of the articles was C. the studies involving 2,366 patients (579 SCLC and 1,847 NSCLC patients that were diagnosed by using the gold standard) were included. The meta-analysis reported that the heterogeneity among studies was high (P=0.005, I2=70.4%), pooled sensitivity was 0.59, 95%CI 0.55 to 0.64, and pooled specificity was 0.88, 95%CI 0.87 to 0.90. The likelihood ratio was 8.17 and 0.31, respectively. The summary ROC of the meta-disc software and the area under the curve was 0.905 0. These data suggested that NSE had a relatively high false negative rate (41%) and a relatively low false positive rate (12%).
Conclusion The tumor marker NSE is has diagnostic value of small cell lung cancer, but more high quality trials are required.
Citation： TANG Jianhua,SU Feng,XU Jinning,DONG Mei,AN Maomao,WANG Rui. Diagnosis Value of Tumor Marker: The Serum Neuron Specific Enolase of Small Cell Lung Cancer in RIA: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(5): 531-535. doi: 10.7507/1672-2531.20090098 Copy