title: Diagnostic value of mutation-specific antibodies for immunohistochemical detection of epidermal growth factor receptor mutations in non-small cell lung cancer: a meta-analysis.
abstract: BACKGROUND
  Various studies have assessed the diagnostic accuracy of EGFR mutation-specific antibodies in non-small cell lung cancer (NSCLC). We performed a meta-analysis of existing data to investigate the diagnostic value of mutation-specific antibodies for detection of EGFR mutations in NSCLC.
  
  
  METHODS
  We systematically retrieved relevant studies from PubMed, Web of Knowledge, and Google Scholar. Data from studies that met the inclusion criteria were extracted for further exploration of heterogeneity, including calculation of the average sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and analysis of SROC(summary receiver operating characteristic) curves.
  
  
  RESULTS
  Fifteen studies met our inclusion criteria. A summary of the meta-analysis of the efficacy of the anti-E746-A750 antibody was as follows: sensitivity, 0.60 (95% CI, 0.55-0.64); specificity, 0.98 (95% CI, 0.97-0.98); PLR, 33.50 (95% CI, 13.96-80.39); NLR, 0.39 (95% CI, 0.30-0.51) and DOR, 111.17 (95% CI, 62.22-198.63). A similar meta-analysis was performed for the anti-L858R antibody with results as follows: sensitivity, 0.76 (95% CI, 0.71-0.79); specificity, 0.96 (95% CI, 0.95-0.97); PLR, 24.42 (95% CI, 11.66-51.17); NLR, 0.22 (95% CI, 0.12-0.39) and DOR, 126.66 (95% CI, 54.60-293.82).
  
  
  CONCLUSIONS
  Immunohistochemistry alone is sufficient for the detection of EGFR mutations if the result is positive. Molecular-based analyses are necessary only if the anti-E746-A750 antibody results are negative. Immunohistochemistry seems more suitable for clinical screening for EGFR mutations prior to molecular-based analysis.
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, P. R. China.
authors.forename: Zi
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, P. R. China.
authors.forename: Hong-bing
authors.initials: HB
authors.lastname: Liu
authors.affiliation: Department of medical Engineering, Jinling Hospital, The Second Military Medical University, Nanjing, P. R. China.
authors.forename: Chun-hua
authors.initials: CH
authors.lastname: Yu
authors.affiliation: Department of Respiratory Medicine, Yijishan Hospital, Wannan Medical Collage, Wuhu, P. R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, P. R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, P. R. China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Song
mesh_terms: D000906:Antibodies / Q000276:immunology*; D000918:Antibody Specificity; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000235:genetics; D066246:ErbB Receptors / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics; D009154:Mutation
chemical_list: D000906:Antibodies; D066246:ErbB Receptors