Meta-analysis On The Value Of Human Telomerase Reverse Transcriptase In Identifying Benign And Malignant Breast Tumors

Objective To systematically evaluate the clinical value of human telomerase reverse transcriptase(hTERT)in the diagnosis of benign and malignant breast tumors in Asian population.Methods A computer based online search was conducted in CNKI,CBM,VIP database,Wan Fang Data,Pub Med,the Cochrane library(Issue10,2020),Web of Science,EMbase from their inception to November 2020to collect the relevant studies of hTERT for differential diagnosis of benign and malignant breast tumors.Then we screened literature,extracted data and assessed the methodological quality of included studies.Meta-analysis was performed by software Stata 15.0 and Meta-Disc 1.4.Firstly,the ROC curve and Spearman correlation coefficient were used to test whether there has threshold effect.If there has threshold effect,we will calculate by ROC curve,AUC and Q*index.If there doesn’t have threshold effect,chi-square test and I~2were used to quantify the heterogeneity.Then meta regression analysis was used to explore the source of heterogeneity and perform subgroup analysis.Finally,publication bias was analyzed by funnel plot.Results A total of 17 studies involving 1436 patients(malignant group 852,benign group 584)were finally included.The results of Meta-analysis showed that the pooled Sen,Spe,-LR,+LR,and DOR were0.81[95%CI(0.79,0.84)],0.83[95%CI(0.79,0.86)],4.75[95%CI(3.35,6.74)],0.21[95%CI(0.15,0.30)],26.93[95%CI(15.02,48.28)]respectively.All outcome indicators were more than 50%,so random effect model was used for meta-analysis.Meta regression analysis of all factors showed that the main source of heterogeneity was the author’s country.After excluding two foreign literatures,the combined DOR calculated by fixed effect model was35.89,AUC=0.9242,Q*=0.8582.Conclusion hTERT detection has good sensitivity and specificity in the differential diagnosis of benign and malignant breast tumors,and the effect of diagnostic test is fine,which is helpful to the clinical differential diagnosis of benign and malignant breast tumors.