title: The diagnostic value of survivin in malignant pleural effusion: a meta-analysis.
abstract: BACKGROUND
  Survivin in pleural effusion is a promising marker for the diagnosis of malignant pleural effusion.
  
  
  METHODS
  Based on the principles and methods of Cochrane systematic reviews, PubMed, EMBASE, Web of Knowledge (ISI), the Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases were searched to identify studies that assessed the diagnostic value of survivin in pleural effusion for malignant pleural effusion. Stata 12 and Meta-disc 1.4 software were used to test the heterogeneity and to perform the meta-analysis.
  
  
  RESULTS
  Our search returned 167 articles, of which ten fulfilled the inclusion criteria. These studies included a total of 614 patients with malignant pleural effusion and 430 patients with benign pleural effusion as controls. The summary assessments revealed that the pooled sensitivity was 0.86 (95% CI: 0.82-0.88) and the pooled specificity was 0.92 (95% CI: 0.89-0.94). The positive likelihood ratio was 8.76 (95% CI: 5.41-14.20), the negative likelihood ratio was 0.16 (95% CI: 0.13-0. 20) and the diagnostic odds ratio (DOR) was 59.72 (95% CI: 39.60-90.05). The area under the curve (AUC) for the pleural effusion survivin tests was 0.9485, and the *Q index estimate for these tests was 0.8885.
  
  
  CONCLUSIONS
  Survivin in pleural effusion has potential diagnostic value with advanced sensitivity and specificity and it can be used as adjunct tool for non-invasive diagnosis of malignant pleural effusion.
authors.affiliation: Department of Respiratory Medicine, Affiliated Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing University of Traditional Chinese Medicine, Nanjing 210029, PR China.
authors.forename: Shi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine, Affiliated Wuxi City Hospital of Traditional Chinese Medicine, Nanjing University of Traditional Chinese Medicine, Wuxi, 214071, China.
authors.forename: Yunfang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Gerontology, The Affiliated Zhong Da Hospital of Southeast University, 87 Dingjiaqiao, Nanjing 210009, PR China.
authors.forename: Li
authors.initials: L
authors.lastname: An
authors.affiliation: Department of Respiratory Medicine, NO4 Hospital of huai'an, Huai'an, Jiangsu, 223002, PR China.
authors.forename: Zhong-ting
authors.initials: ZT
authors.lastname: Fei
authors.affiliation: Department of Respiratory Medicine, Nanjing Chest Hopital, Nanjing, Jiangsu, 210029, PR China. Electronic address: cshonest@yeah.net.
authors.forename: Tian
authors.initials: T
authors.lastname: Li
mesh_terms: D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000032:analysis*; D016066:Pleural Effusion, Malignant / Q000175:diagnosis*; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin
keywords: Diagnostic; Malignant pleural effusion; Meta-analysis; Survivin; Systematic review