Macrophage Inhibitory Cytokine-1 Versus Carbohydrate Antigen 19–9 As A Biomarker For Diagnosis Of Pancreatic Cancer A Prisma-compliant Meta-analysis Of Diagnostic Accuracy Studies

Background: Because of the high malignant degree of pancreatic cancer,the early diagnosis of pancreatic cancer(PC)is of great concern.Macrophage inhibitory cytokine-1(MIC-1)was reported to be a potential diagnostic biomarker,but its diagnostic value is indeterminate.Therefore,we performed this meta-analysis to compare it to carbohydrate antigen 19-9(CA19-9),the most frequently-used serum biomarker in PC.Material and Methods: After a system review of the relevant studies,the pooled diagnostic indices including sensitivity,specificity,positive/negative likelihood ratio(PLR/NLR),diagnostic odds ratio(DOR),summary receiver operating characteristic curve(sROC)and area under the SROC curve(AUC)were used to evaluate the diagnostic value of MIC-1and CA19-9 for PC.These indices were pooled with random-effects models.We explored the heterogeneity by meta-regression.Results: 14 studies comprising a total of 2826 subjects were included in our meta-analysis.The summary estimates for MIC-1 and CA19-9 are listed as follows: sensitivity,80%(95% confidence interval [CI] 78-82%)vs.71%(68-73%);specificity,85%(95% CI 83-87%)vs.88%(86-90%);DOR,24.57(95% CI 14.00-43.10)vs.17.65(11.65-26.76);area under sROC(AUC),0.8945 vs.0.8322;PLR,5.18(95% CI 3.24-8.26)vs.5.34(3.78-7.54);and NLR,0.23(95% CI 0.19-0.29)vs.0.32(0.28-0.37).Conclusions: These data demonstrate that serum MIC-1 has a comparable diagnostic accuracy to CA19-9 for PC.