Diagnostic Value of Nonacid Nucleic Blood Tumor Marker Panels in Early Diagnosing Breast Cancer: A Systematic Review and Network Meta-Analysis

Abstract

This study is aimed at determining the best nonacid nucleic blood tumor marker panels in terms of sensitivity, specificity, and accuracy in order to detect breast cancer in early stages (I, II, and III) among eligible women for breast cancer screening. PubMed, Web of Science, Embase, Scopus, and Cochrane were systematically reviewed to assess nonacid nucleic blood tumor marker panels’ diagnostic value in women, both healthy and patient (before any anticancer treatment), for detecting breast cancer. A network meta-analysis was carried out using a Bayesian network meta-analysis to estimate combined odd ratio (OR) and 95% CI credible interval for presenting the results. Rankograms plot was drawn to rank the diagnostic value of different panels. Of the 2358 titles initially identified, 9 studies and 8 panels were included in the network meta-analysis. Panels A (MMP-9/TIMP-1) and K (TF1+TF2+TF3) had the highest sensitivity in early stages, as panel A with OR = 11.61 and 95% CI (1.49-102.5) demonstrated a better function than mammography. Panels H (CA 15.3 + IL-18) and A (MMP-9/TIMP-1) had the highest specificity in early stages, but no significant difference with mammography. Panels A (MMP-9/TIMP-1) and H (CA 15.3 + IL-18) had the highest accuracy in early stages, as they significantly exhibited a higher function than mammography with OR = 6.87 and 95% CI (2.07-31.35) as well as OR = 3.44 and 95% CI (1.15-11.07), respectively. Panel A including MMP-9/TIMP-1 in early stages demonstrated a higher diagnostic value for breast cancer than the rest of the panels.

A Short Communication: Non-acid Nucleic Blood Multi-Factors Panels for Primary Breast Cancer Detection – A Systematic Review and Network Meta-Analysis

“…The systematic reviews of the observational studies were conducted based on PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Metaanalysis) [4]. Eligibility criteria, search strategy (supplementary material 1 B), databases, study selection, data extraction, and statistical analysis conformed to our former study [1]. The difference is that, in this brief study, we systematically reviewed the studies that have simultaneously assessed several tumor markers in the form of a panel to diagnose and detect breast cancer in all stages of primary breast cancer (I, II, III, and IV).…”

“…We conducted direct and indirect paired comparisons of the sensitivity, specificity, and accuracy of the included blood tumor markers panels for diagnosing primary breast cancer in all stages. All the investigations were conducted in comparison to mammography (M) as the gold standard [6][7][8], like our previous study (Figure 1) [1].…”

“…Study selection conformed to our former study [1]. However, in this brief study, among the 54 studies relevant to our research question which contained 86 unique blood tumor markers panels (supplementary material 2) conforming to our eligibility criteria, only 12 studies and 9 panels presented enough data for estimating sensitivity and specificity in all stages (I, II, III, and IV) of primary breast cancer and could be included in the systematic review and network meta-analysis.…”

“…Based on our previous study [1], the necessity of a noninvasive, accessible, costeffective, and reliable method for breast cancer detection based on blood factors was proved. Furthermore, blood multi-factor panels can be the best choice for such a method thanks to improving the sensitivity and specificity of cancer detection considerably compared to the individual state.…”

“…Furthermore, blood multi-factor panels can be the best choice for such a method thanks to improving the sensitivity and specificity of cancer detection considerably compared to the individual state. In that study [1], we had determined the best non-acid nucleic blood multi-factor panels for breast cancer detection in early stages and locoregional breast cancer (I, II, and III). In this brief study, however, we compared the best non-acid nucleic blood multi-factor panels in primary breast cancer detection (I, II, III, and IV) by conducting a network meta-analysis.…”