title: Diagnostic value of multiple tumor markers for patients with esophageal carcinoma.
abstract: BACKGROUND
  Various studies assessing the diagnostic value of serum tumor markers in patients with esophageal cancer remain controversial. This study aims to comprehensively and quantitatively summarize the potential diagnostic value of 5 serum tumour markers in esophageal cancer.
  
  
  METHODS
  We systematically searched PubMed, Embase, Chinese National Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM), through February 28, 2013, without language restriction. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were pooled separately and compared with overall accuracy measures using diagnostic odds ratios (DORs) and symmetric summary receiver operating characteristic (SROC) curves.
  
  
  RESULTS
  Of 4391 studies initially identified, 44 eligible studies including five tumor markers met the inclusion criteria for the meta-analysis, while meta-analysis could not be conducted for 12 other tumor markers. Approximately 79.55% (35/44) of the included studies were of relatively high quality (QUADAS score≥7). The summary estimates of the positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) for diagnosing EC were as follows: CEA, 5.94/0.76/9.26; Cyfra21-1, 12.110.59/22.27; p53 antibody, 6.71/0.75/9.60; SCC-Ag, 7.66/0.68/12.41; and VEGF-C, 0.74/0.37/8.12. The estimated summary receiver operating characteristic curves showed that the performance of all five tumor markers was reasonable.
  
  
  CONCLUSIONS
  The current evidence suggests that CEA, Cyfra21-1, p53, SCC-Ag and VEGF-C have a potential diagnostic value for esophageal carcinoma.
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, China.
authors.forename: Zhenli
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of International Center for Liver Disease Treatment, 302 PLA hospital, No. 100 Xisihuan Road, Beijing, 100017, China.
authors.forename: Xueyuan
authors.initials: X
authors.lastname: Jin
authors.affiliation: Department of Medical Quality Control, 302 PLA Hospital, No. 100 Xisihuan Road, Beijing, 100017, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, China.
authors.forename: Qiuyan
authors.initials: Q
authors.lastname: Yu
authors.affiliation: Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Li
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D004938:Esophageal Neoplasms / Q000097:blood* / Q000175:diagnosis*; D006801:Humans
chemical_list: D014408:Biomarkers, Tumor