Diagnostic value of mesothelinin pancreatic cancer: a meta-analysis.

BACKGROUND AND OBJECTIVES An increasing number of studies have examined the ability of mesothelin to be a marker for the diagnosis of pancreatic cancer (PCa). The exact role of mesothelin needs to be elucidated. The aim of this study is to determine the overall accuracy of mesothelinin PCa through a meta-analysis of published studies. MATERIALS AND METHODS Publications addressing the accuracy of mesothelin in the diagnosis of PCa were selected from Pubmed, Embase, Cochrane Library, Web of Science, and The Chinese Journals Full-text Database (CNKI). The following indexes of test accuracy were computed for eachstudy: sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). The diagnostic threshold identified for each study wasused to plot a summary receiver operating characteristic (SROC) curve. Statistical analysis was performed by Meta-Disc1.4 and STATA 12.0 software. RESULTS 12 studies met the inclusion criteria. The summary estimates for mesothelin in the diagnosis of PCa were: sensitivity 0.71 (95% CI, 0.67-0.75), specificity 0.88 (95% CI, 0.85-0.91), positive likelihood ratio (PLR) 8.53 (95% CI, 3.42-21.27), negative likelihood ratio (NLR) 0.36 (95% CI, 0.28-0.46)and diagnostic odds ratio 33.93 (95% CI, 10.71-107.5). The SROC curveindicated that the maximum joint sensitivity and specificity (Q-value) was 0.81; the area under the curve was 0.88. CONCLUSION Our findings suggest that mesothelin may be a useful diagnostic adjunctive tool for confirming PCa. However, further large scale studies are needed to confirm these findings.