Systematic Review and Meta-Analysis to Identify the Immunocytochemical Markers Effective in Delineating Benign from Malignant Thyroid Lesions in FNAC Samples
Abstract Conventional cytology-based diagnosis for thyroid cancer is limited with more than 30–45% of nodules categorized as indeterminate, necessitating surgery for confirming or refuting the diagnosis. This systematic review and meta-analysis were aimed at identifying immunocytochemical markers effective in delineating benign from malignant thyroid lesions in fine needle aspiration cytology (FNAC) samples, thereby improving the accuracy of cytology diagnosis. A systematic review of relevant articles (2000–2021) from online databases was carried out and the search protocol registered in PROSPERO database (CRD42021229121). The quality of studies was assessed using QUADAS-2. Review Manager 5.4.1 from Cochrane collaboration and MetaDisc Version 1.4 was used to conduct the meta-analysis. Bias in the studies were visually analyzed using funnel plots, and statistical significance was evaluated by Egger’s test. Systematic review identified 64 original articles, while meta-analysis in eligible articles (n = 41) identified a panel of 5 markers, Galectin-3, HBME-1, CK-19, CD-56, and TPO. Assessment of the diagnostic performance revealed that Gal-3 (sensitivity: 0.81; CI: 0.79–0.83; specificity: 0.84; CI: 0.82–0.85) and HBME-1 (sensitivity: 0.83; Cl: 0.81–0.86; specificity: 0.85; CI: 0.83–0.86) showed high accuracy in delineating benign from malignant thyroid nodules. Efficacy analysis in indeterminate nodules showed Gal-3 and HBME-1 have high specificity of 0.86 (CI 0.84–0.89) and 0.82 (CI 0.78–0.86), respectively, and low sensitivity of 0.76 (CI 0.72–0.80) and 0.75 (CI 0.70–0.80), respectively. Diagnostic odds ratio (DOR) of Galectin-3 and HBME-1 were 39.18 (CI 23.38–65.65) and 24.44 (CI 11.16–53.54), respectively. Significant publication bias was observed for the markers Galectin-3 and CK-19 (p < 0.05). The panel of 5 markers identified from this meta-analysis are high-confidence candidates that need to be validated in thyroid cytology to establish their efficacy and enable clinical applicability..
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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Enthalten in: |
Endocrine pathology - 33(2022), 2 vom: 21. Mai, Seite 243-256 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Mohan, Uma [VerfasserIn] |
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Volltext [lizenzpflichtig] |
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Themen: |
Galectin-3 |
Anmerkungen: |
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022 |
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doi: |
10.1007/s12022-022-09721-5 |
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funding: |
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PPN (Katalog-ID): |
OLC2130681204 |
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520 | |a Abstract Conventional cytology-based diagnosis for thyroid cancer is limited with more than 30–45% of nodules categorized as indeterminate, necessitating surgery for confirming or refuting the diagnosis. This systematic review and meta-analysis were aimed at identifying immunocytochemical markers effective in delineating benign from malignant thyroid lesions in fine needle aspiration cytology (FNAC) samples, thereby improving the accuracy of cytology diagnosis. A systematic review of relevant articles (2000–2021) from online databases was carried out and the search protocol registered in PROSPERO database (CRD42021229121). The quality of studies was assessed using QUADAS-2. Review Manager 5.4.1 from Cochrane collaboration and MetaDisc Version 1.4 was used to conduct the meta-analysis. Bias in the studies were visually analyzed using funnel plots, and statistical significance was evaluated by Egger’s test. Systematic review identified 64 original articles, while meta-analysis in eligible articles (n = 41) identified a panel of 5 markers, Galectin-3, HBME-1, CK-19, CD-56, and TPO. Assessment of the diagnostic performance revealed that Gal-3 (sensitivity: 0.81; CI: 0.79–0.83; specificity: 0.84; CI: 0.82–0.85) and HBME-1 (sensitivity: 0.83; Cl: 0.81–0.86; specificity: 0.85; CI: 0.83–0.86) showed high accuracy in delineating benign from malignant thyroid nodules. Efficacy analysis in indeterminate nodules showed Gal-3 and HBME-1 have high specificity of 0.86 (CI 0.84–0.89) and 0.82 (CI 0.78–0.86), respectively, and low sensitivity of 0.76 (CI 0.72–0.80) and 0.75 (CI 0.70–0.80), respectively. Diagnostic odds ratio (DOR) of Galectin-3 and HBME-1 were 39.18 (CI 23.38–65.65) and 24.44 (CI 11.16–53.54), respectively. Significant publication bias was observed for the markers Galectin-3 and CK-19 (p < 0.05). The panel of 5 markers identified from this meta-analysis are high-confidence candidates that need to be validated in thyroid cytology to establish their efficacy and enable clinical applicability. | ||
650 | 4 | |a Thyroid | |
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700 | 1 | |a Kannan, Subramanian |4 aut | |
700 | 1 | |a Suresh, Amritha |4 aut | |
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