Abstract | BACKGROUND/OBJECTIVE: METHODS: We conducted a meta-analysis for the diagnostic utility of the four major altered genes in PDAC (KRAS, CDKN2A/p16, TP53, and SMAD4/DPC4), telomerase activity, and a combination assay using PJ samples. A literature search was conducted in MEDLINE, Cochrane Library, and Web of Science. Data were pooled and presented as diagnostic sensitivity and specificity with 95% confidence intervals (CIs). RESULTS: Thirty-nine studies fulfilled the inclusion criteria. Pooled estimates of KRAS analysis were as follows: sensitivity was 0.67 (95% CI, 0.63-0.71) and specificity, 0.82 (95% CI, 0.79-0.85). For telomerase activity analysis, sensitivity was 0.82 (95% CI, 0.76-0.87) and specificity, 0.96 (95% CI, 0.90-0.99). The other three tumor suppressors demonstrated low sensitivity. The data did not suggest any publication bias. A combined analysis of KRAS and telomerase activity showed a higher diagnostic sensitivity (0.94; 95% CI, 0.83-0.99) than KRAS alone. A combined analysis of telomerase activity and cytology revealed more reliable diagnostic accuracy than telomerase activity alone, with high sensitivity (0.88; 95% CI, 0.74-0.96) and specificity (1.00; 95% CI, 0.91-1.00). CONCLUSIONS: The most reliable marker in PJ samples for diagnosis of PDAC was telomerase activity. Telomerase activity can play a central role in diagnostic analysis using PJ samples, and can increase diagnostic accuracy when combined with KRAS mutations or cytological examination.
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Authors | Tatsuo Hata, Masaharu Ishida, Fuyuhiko Motoi, Takuhiro Yamaguchi, Takeshi Naitoh, Yu Katayose, Shinichi Egawa, Michiaki Unno |
Journal | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
(Pancreatology)
2016 May-Jun
Vol. 16
Issue 3
Pg. 372-81
ISSN: 1424-3911 [Electronic] Switzerland |
PMID | 26899542
(Publication Type: Journal Article, Meta-Analysis)
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Copyright | Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved. |
Chemical References |
- Biomarkers, Tumor
- Genetic Markers
- Telomerase
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Topics |
- Biomarkers, Tumor
(genetics, metabolism)
- Carcinoma, Pancreatic Ductal
(diagnosis, enzymology, genetics)
- Diagnosis, Differential
- Genetic Markers
- Humans
- Pancreatic Juice
(enzymology)
- Pancreatic Neoplasms
(diagnosis, enzymology, genetics)
- Pancreatitis, Chronic
(diagnosis, enzymology)
- Sensitivity and Specificity
- Telomerase
(metabolism)
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