| Background and Objective:Crizotinib, a targeted anticancer agent, has been proved to be a favorable treatment option for anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC). Currently, diagnostic methods for identifying ALK rearrangements include fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), and polymerase chain reaction (PCR). The aim of this study is to evaluate the diagnostic value of IHC and PCR for ALK+NSCLC by Meta-analysis.Methods:All required English and Chinese literatures in Pubmed, Embase, Cochrane Library, Chinese Biological Medical Literature Database (CBMdisc), China National Knowledge Infrastructure (CNKI), Wanfang and VIP database were searched. Then further screening based on the inclusion and exclusion criteria. Meta-analysis of diagnostic test was applied to analyze the sensitivity and specificity of IHC and PCR for the detection of ALK+NSCLC.Results:Nine studies were included in the Meta-analysis, there were 2,041 samples. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) of Ventana-IHC in the diagnosis of ALK+NSCLC were 0.94(95%CI 0.90-0.97),1.00(95%CI 0.99-1.00), 75.99(95%CI 42.91-134.56),0.10(95%CI 0.04-0.22) and 950.48(95%CI 399.11-2263.54), respectively. The area under curve (AUC) of summary receiver operating characteristic (SROC) was 0.9962(SEAUC 0.0041), The Q* value was 0.9766(SEQ* 0.0149). Conventional IHC had more influence factors than Ventana-IHC. In order to ensure the homogeneity of this Meta-analysis, it had been ruled out. The studies of PCR for diagnose of ALK+NSCLC is less, and Meta-analysis could not be carried out.Conclusions:The specificity and sensitivity of Ventana-IHC were relatively high. In a certain degree, Ventana-IHC could be substituted for FISH to be used in the diagnosis of ALK+ NSCLC, and had clinical pratical value. |
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