首页膀胱肿瘤治疗及预后证据详情

Diagnostic value of urinary survivin as a biomarker for bladder cancer: a systematic review and meta-analysis of published studies

原文: 2018 年 发布于 Ann Afr Med 32 卷 第 4 期 919-927 浏览量:269次

作者: Liang Z. Xin R. Yu Y. Wang R. Wang C. Liu X.

作者单位: Department of Population Health Sciences, University of Texas Health San Antonio, San Antonio, TX, USA. John B. Alexander High School, Laredo, TX, USA. Mays Cancer Center at University of Texas Health San Antonio MD Anderson, San Antonio, TX, USA. Institute for Health Promotion Research, University of Texas Health San Antonio, San Antonio, TX, USA. Department of Urology, University of Texas Health San Antonio, San Antonio, TX, USA. Markey Cancer Center, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1111/ans.16740

关键词: Case-Control Studies Catechol O-Methyltransferase/*genetics Genetic Association Studies Genetic Predisposition to Disease Genotype Humans Kidney Neoplasms/enzymology/*genetics Male Polymorphism Single Nucleotide Prostatic Neoplasms/enzymology/*genetics Risk Factors Urinary Bladder Neoplasms/enzymology/*genetics

文献简介

Background: The aim of the study was to systematically review the relevant studies to assess the role of fluorescence in situ hybridization (FISH) test for predicting patient response to Bacillus Calmette-Guerin (BCG) therapy after transurethral resection of bladder tumor (TURBT). Methods: We searched PubMed, Embase, and the Cochrane Library from inception to July 5, 2018, and used Quality Assessment Tool for Diagnosis Accuracy Studies (QUADAS-2) to assess the quality. We pooled sensitivity, specificity, and area under curve (AUC) of baseline and post-BCG FISH test for predicting tumor recurrence. Hazard ratio (HR) with 95% confidence intervals (95% CIs) and a Fagan nomogram were applied to assess predictive accuracy of post-BCG FISH test. Results: A total of 6 studies with 442 participants for post-BCG test and 404 participants for baseline BCG test were included. The pooled analysis for post-BCG FISH test revealed the sensitivity of 0.54 (95% CI 0.38-0.69), specificity of 0.84 (95% CI: 0.72-0.91), and area under the curve (AUC) of 0.78 (95% CI: 0.74-0.81) for predicting tumor recurrence. Patients with positive post-BCG FISH test were more likely to recur during follow-up (HR 3.95, 95% CI 2.72-5.72). The Fagan nomogram revealed the `post-test` probability of tumor recurrence increased by 29% for patients with positive post-BCG FISH test. The baseline FISH test had a pooled sensitivity of 0.70 (95% CI 0.55-0.81), specificity of 0.41 (95% CI: 0.26-0.58), and AUC of 0.60 (95% CI: 0.56-0.64) for predicting recurrence. Conclusion: The post-BCG FISH test can predict BCG failure with high specificity and patients with positive post-BCG FISH test were more likely to recur. However, the relatively low sensitivity of post-BCG FISH test and unsatisfactory performance of baseline FISH test may limit their mono-use.

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