Diagnosis Value Of CEA And CYFRA21-1 In Non-Small-Cell Lung Cancer: A Systematic Review

Objective To evaluate the diagnostic value of serum CEA and CYFRA21-1 in patients with suspected non-small-cell lung cancer (NSCLC) with lung pathological diagnosis as the gold standard.Method PubMed, Embase, Cochrane library, Ovid, CBM etc. were searched for studies about serum CEA and CYFRA21-1 in the diagnosis of NSCLC. We screened studies identified for inclusion and determined study eligibility according to the criteria of inclusion and exclusion. The characteristics of the included articles were appraised and extracted. Statistical analysis was performed by Meta-DiSc 1.4 and SPAS 17.0 software. Quality of included trials was assessed by QUADAS. Studies Heterogeneity of the included articles was tested, which was used to select the proper effect model to calculate pooled weighted sensitivity, specificity. Then the Summary Receiver Operating Characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally, subgroup analysis was performed according to the possible heterogeneous sources. Results 38 articles were entered this meta-analysis while 1,679 articles were searched .The studies involved 5,140 NSCLC patients and 3,834 cases as the control group. The meta-analysis reported that the heterogeneity among studies (CEA, CYFRA21-1, CEA+CYFRA21-1) was high .The AUC were 0.7230, 0.8804 and 0.9134, respectively.Conclusion The diagnosis value of CEA and CYFRA21-1 in NSCLC was recognized, contributing to diagnosis of the disease, the combination of CEA and CYFRA21-1 can improve the sensitivity, but CEA provides no additional value when used in combination with CYFRA21-1 in all.