title: Diagnostic value of survivin for malignant pleural effusion: a clinical study and meta-analysis.
abstract: OBJECTIVE
  To investigate the diagnostic accuracy of survivin for malignant pleural effusion (MPE).
  
  
  METHODS
  Pleural effusion samples were collected from 40 MPE patients and 45 non-MPE patients. Pleural levels of survivin were measured by ELISA. Literature search was performed in Pubmed and Embase to identify studies regarding the usefulness of survivin to diagnose MPE. Data were retrieved and the pooled sensitivity, specificity and other diagnostic indexes were calculated. The summary receiver operating characteristics (SROC) curve was used to determine the overall diagnostic accuracy.
  
  
  RESULTS
  The pleural levels of survivin were higher in MPE patients than non-MPE patients (844.17 ± 358.30 vs. 508.08 ± 169.58 pg/ml, P < 0.05), at a cut-off value of 683.2 pg/ml, the sensitivity and specificity were 57.50% and 88.89%, respectively. A total of six studies were included in present meta-analysis, the overall diagnostic estimates were: sensitivity 0.74 (95% CI: 0.59-0.85); specificity, 0.85 (95% CI: 0.79-0.89); positive likelihood ratio, 4.79 (95% CI: 3.48-6.61); negative likelihood ratio, 0.31 (95% CI: 0.19-0.50), and diagnostic odds ratio, 15.59 (95% CI: 7.69-31.61). The area under SROC curve was 0.86 (95% CI: 0.82-0.89).
  
  
  CONCLUSIONS
  Our study confirms that the pleural survivin plays a role in the diagnosis of MPE. More studies at a large scale should be performed to validate our findings.
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Panwen
authors.initials: P
authors.lastname: Tian
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Yongchun
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Wan
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Jing
authors.initials: J
authors.lastname: An
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Yi
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China Chengdu 610041, China.
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Wen
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000032:analysis*; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D019152:Paracentesis; D016066:Pleural Effusion, Malignant / Q000737:chemistry*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin
keywords: Survivin; diagnosis; malignant pleural effusion; meta-analysis