Diagnostic accuracy of Cyfra 21-1 for head and neck squamous cell carcinoma: a meta-analysis.
OBJECTIVE
The role of Cyfra 21-1 in diagnosing squamous cell carcinoma of head and neck is not yet clear. The present meta-analysis aimed to establish the overall diagnostic accuracy of Cyfra 21-1 for head and neck squamous cell carcinoma.


METHODS
After a systematic literature review and selection of English language studies, sensitivity, specificity and other measures of accuracy of Cyfra 21-1 in the diagnosis of head and neck squamous cell carcinoma were pooled using random effects models. Summary receiver operating characteristic curve was used to summarize overall diagnostic performance. Publication bias was examined by Deeks' funnel plot.


RESULTS
Thirteen studies with 2269 subjects met the inclusion criteria for the analysis. The pooled sensitivity and specificity of Cyfra 21-1 for diagnosing head and neck squamous cell carcinoma were 0.51 (95%CI: 0.48-0.54) and 0.97 (95%CI: 0.95-0.98), respectively. The positive likelihood ratio was 10.11 (95%CI: 6.50-15.71), negative likelihood ratio was 0.52 (95%CI: 0.41-0.66) and diagnostic odds ratio was 25.60 (95%CI: 13.39-48.96). The area under the summary receiver operating characteristic curve was 0.94.


CONCLUSIONS
The evidence from current meta-analysis suggests Cyfra 21-1 plays a valuable role in the diagnosis of head and neck squamous cell carcinoma with high specificity. The results of tumor marker assays should be interpreted in parallel with clinical findings and the results of conventional tests.
Department of Stomatology, Zhengzhou People's Hospital Affiliated to Southern Medical University, Zhengzhou, China. wangyunxia0828@163.com  
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D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D053539:Keratin-19 / Q000097:blood*; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D012372:ROC Curve; D012680:Sensitivity and Specificity
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; C102012:antigen CYFRA21.1