Limits...
A systematic review and meta-analysis of diagnostic and prognostic serum biomarkers of colorectal cancer.

Liu Z, Zhang Y, Niu Y, Li K, Liu X, Chen H, Gao C - PLoS ONE (2014)

Bottom Line: The databases MEDLINE and EMBASE were searched iteratively to identify the relevant literature for serum markers of CRC published from 1950 to August 2012.All of the pooled sensitivities of the diagnostic markers with > = 3 repetitions were less than 50%, and the meta-analyses of the prognostic markers with more than 3 studies were performed, VEGF with highest (2.245, CI: 1.347-3.744) and MMP-7 with lowest (1.099, CI: 1.018-1.187)) pooled HRs are presented.The poor characteristics indicate that these tests are of little value for clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Anal-Colorectal Surgery Institute, Central Hospital of PLA, Luoyang, Henan, China.

ABSTRACT

Background: Our systematic review summarizes the evidence concerning the accuracy of serum diagnostic and prognostic tests for colorectal cancer (CRC).

Methods: The databases MEDLINE and EMBASE were searched iteratively to identify the relevant literature for serum markers of CRC published from 1950 to August 2012. The articles that provided adequate information to meet the requirements of the meta-analysis of diagnostic and prognostic markers were included. A 2-by-2 table of each diagnostic marker and its hazard ratio (HR) and the confidence interval (CI) of each prognostic marker was directly or indirectly extracted from the included papers, and the pooled sensitivity and specificity of the diagnostic marker and the pooled HR and the CI of the prognostic marker were subsequently calculated using the extracted data.

Results: In total, 104 papers related to the diagnostic markers and 49 papers related to the prognostic serum markers of CRC were collected, and only 19 of 92 diagnostic markers were investigated in more than two studies, whereas 21 out of 44 prognostic markers were included in two or more studies. All of the pooled sensitivities of the diagnostic markers with > = 3 repetitions were less than 50%, and the meta-analyses of the prognostic markers with more than 3 studies were performed, VEGF with highest (2.245, CI: 1.347-3.744) and MMP-7 with lowest (1.099, CI: 1.018-1.187)) pooled HRs are presented.

Conclusions: The quality of studies addressing the diagnostic and prognostic accuracy of the tests was poor, and the results were highly heterogeneous. The poor characteristics indicate that these tests are of little value for clinical practice.

Show MeSH

Related in: MedlinePlus

Summary of quality of the included studies, according to the QUADAS criteria (see Table S2 for details).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4126674&req=5

pone-0103910-g002: Summary of quality of the included studies, according to the QUADAS criteria (see Table S2 for details).

Mentions: The quality of diagnosis papers was assessed by using the QUADAS system [11]. The methodological quality of the studies with a focus on the objective of this review was generally poor and are shown in Figure 2, with specific details in Table S2 (references to these studies are prefaced by a ‘D’ and are listed in Appendix 4 in Materials S1). Of the studies, 12 papers were designed using a prospective cohort study. The rest of studies used case-control methods. Therefore, verification bias inevitably appeared in those studies. Verification bias is the result of identifying experimental groups by the gold standard reference test of a disease or condition, such as cancer, whereas the control group is presumed to be free of this condition, but this is not verified by the gold standard reference test, which inflates sensitivity and decreases specificity [34]–[36]. Moreover, most studies did not have an adequate description of the patient-selection procedure, the characteristics of the study participants, the reference standard, and the used cut-off value of the marker. The time between the index test (marker) and the reference test as well as the availability of other clinical data (as is commonly encountered in practice) were also poorly reported.


A systematic review and meta-analysis of diagnostic and prognostic serum biomarkers of colorectal cancer.

Liu Z, Zhang Y, Niu Y, Li K, Liu X, Chen H, Gao C - PLoS ONE (2014)

Summary of quality of the included studies, according to the QUADAS criteria (see Table S2 for details).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126674&req=5

pone-0103910-g002: Summary of quality of the included studies, according to the QUADAS criteria (see Table S2 for details).
Mentions: The quality of diagnosis papers was assessed by using the QUADAS system [11]. The methodological quality of the studies with a focus on the objective of this review was generally poor and are shown in Figure 2, with specific details in Table S2 (references to these studies are prefaced by a ‘D’ and are listed in Appendix 4 in Materials S1). Of the studies, 12 papers were designed using a prospective cohort study. The rest of studies used case-control methods. Therefore, verification bias inevitably appeared in those studies. Verification bias is the result of identifying experimental groups by the gold standard reference test of a disease or condition, such as cancer, whereas the control group is presumed to be free of this condition, but this is not verified by the gold standard reference test, which inflates sensitivity and decreases specificity [34]–[36]. Moreover, most studies did not have an adequate description of the patient-selection procedure, the characteristics of the study participants, the reference standard, and the used cut-off value of the marker. The time between the index test (marker) and the reference test as well as the availability of other clinical data (as is commonly encountered in practice) were also poorly reported.

Bottom Line: The databases MEDLINE and EMBASE were searched iteratively to identify the relevant literature for serum markers of CRC published from 1950 to August 2012.All of the pooled sensitivities of the diagnostic markers with > = 3 repetitions were less than 50%, and the meta-analyses of the prognostic markers with more than 3 studies were performed, VEGF with highest (2.245, CI: 1.347-3.744) and MMP-7 with lowest (1.099, CI: 1.018-1.187)) pooled HRs are presented.The poor characteristics indicate that these tests are of little value for clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Anal-Colorectal Surgery Institute, Central Hospital of PLA, Luoyang, Henan, China.

ABSTRACT

Background: Our systematic review summarizes the evidence concerning the accuracy of serum diagnostic and prognostic tests for colorectal cancer (CRC).

Methods: The databases MEDLINE and EMBASE were searched iteratively to identify the relevant literature for serum markers of CRC published from 1950 to August 2012. The articles that provided adequate information to meet the requirements of the meta-analysis of diagnostic and prognostic markers were included. A 2-by-2 table of each diagnostic marker and its hazard ratio (HR) and the confidence interval (CI) of each prognostic marker was directly or indirectly extracted from the included papers, and the pooled sensitivity and specificity of the diagnostic marker and the pooled HR and the CI of the prognostic marker were subsequently calculated using the extracted data.

Results: In total, 104 papers related to the diagnostic markers and 49 papers related to the prognostic serum markers of CRC were collected, and only 19 of 92 diagnostic markers were investigated in more than two studies, whereas 21 out of 44 prognostic markers were included in two or more studies. All of the pooled sensitivities of the diagnostic markers with > = 3 repetitions were less than 50%, and the meta-analyses of the prognostic markers with more than 3 studies were performed, VEGF with highest (2.245, CI: 1.347-3.744) and MMP-7 with lowest (1.099, CI: 1.018-1.187)) pooled HRs are presented.

Conclusions: The quality of studies addressing the diagnostic and prognostic accuracy of the tests was poor, and the results were highly heterogeneous. The poor characteristics indicate that these tests are of little value for clinical practice.

Show MeSH
Related in: MedlinePlus