Serum Carbohydrate Antigen 19-9 in Differential Diagnosis of Benign and Malignant Pancreatic Cystic Neoplasms: A Meta-Analysis.
BACKGROUND
Using serum carbohydrate antigen 19-9 (CA 19-9) in discriminating between benign and malignant pancreatic disease remains controversial. We aim to evaluate the diagnostic value of serum CA 19-9 in predicting malignant pancreatic cystic lesions.


METHODS
Eligible studies were identified through searching MEDLINE and EMBASE prior to March 2016. Studies were assessed for quality using the Quality Assessment for Studies of Diagnostic Accuracy, 2nd version (QUADAS-2). Pooled sensitivity and specificity with 95% confidence interval (CI) were calculated using random-effects models. Summary receiver operator characteristic (SROC) curves and the area under curve (AUC) were performed.


RESULTS
A total of thirteen studies including 1437 patients were enrolled in this meta-analysis. The pooled sensitivity and specificity were 0.47(95% CI: 0.35-0.59), and 0.88(95% CI: 0.86-0.91), respectively, and the AUC was 0.87(95% CI, 0.84-0.90). Meta-regression analysis showed that sample size, region and reference standards were not the main sources of heterogeneity.


CONCLUSIONS
Serum CA 19-9 has satisfying pooled specificity while poor pooled sensitivity for discriminating benign from malignant PCNs. It deserves to be widely used as complementary to other clinical diagnostic methods.
Department of General Surgery, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing, 100730, China.
Shaobo
S
Cao
Department of General Surgery, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing, 100730, China.
Ya
Y
Hu
Department of General Surgery, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing, 100730, China.
Xiang
X
Gao
Department of General Surgery, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing, 100730, China.
Quan
Q
Liao
Department of General Surgery, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing, 100730, China.
Yupei
Y
Zhao
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D010179:Pancreas / Q000378:metabolism / Q000473:pathology; D010181:Pancreatic Cyst / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D011446:Prospective Studies; D012372:ROC Curve; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen