CA153 in Breast Secretions as a Potential Molecular Marker for Diagnosing Breast Cancer: A Meta Analysis

Purpose
Many studies have reported that carbohydrate antigen 153 (CA153) in breast secretions (BS) can discriminate breast cancer (BC) patients from healthy individuals, indicating CA153 in BS as a potential index for BC. This meta-analysis aimed to evaluate the actual diagnostic value of CA153 in BS.
Methods
Related papers were obtained from Pubmed, Embase, Scopus, Ovid, Sciverse, the Cochrane library, Chinese Biomedical literature Database (CBM), Technology of Chongqing (VIP), Wan Fang Data, and Chinese National Knowledge Infrastructure (CNKI). Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CA153 in BS for BC diagnosis were analyzed with the random effect model. SROC and the area under the curve (AUC) were applied to assess overall diagnostic efficiency.
Results
This meta-analysis included five studies with a total of 329 BC patients and 381 healthy subjects. For CA153 in BS, the summary sensitivity, specificity, and DOR to diagnose BC were 0.63 (95% confidence interval (CI): 0.57∼0.68), 0.82 (95% CI: 0.78∼0.86), and 9.18 (95% CI: 4.22∼19.95), respectively. Furthermore, the AUC of BS CA153 in the diagnosis of BC was 0.8614.
Conclusions
CA153 in BS is a valuable molecular marker in diagnosing BC and should be applied in standard clinical practices of BC screening upon confirmation of our findings in a larger prospective study.

研究背景与目的 多项研究表明，乳腺分泌物（breast secretions, BS）中的碳水化合物抗原153（carbohydrate antigen 153, CA153）可用于区分乳腺癌（breast cancer, BC）患者与健康个体，提示BS中CA153有望作为BC的潜在检测指标。本荟萃分析旨在评估BS中CA153实际的诊断价值。
研究方法 从PubMed、Embase、Scopus、Ovid、Sciverse、Cochrane图书馆、中国生物医学文献数据库（Chinese Biomedical literature Database, CBM）、重庆维普资讯（Technology of Chongqing, VIP）、万方数据以及中国知网（Chinese National Knowledge Infrastructure, CNKI）中检索相关文献。采用随机效应模型合并分析BS中CA153诊断BC的合并灵敏度、特异度及诊断比值比（diagnostic odds ratio, DOR）。通过综合受试者工作特征曲线（summary receiver operating characteristic curve, SROC）及其曲线下面积（area under the curve, AUC）评估整体诊断效能。
研究结果 本荟萃分析共纳入5项研究，涉及329例BC患者与381名健康受试者。BS中CA153诊断BC的合并灵敏度、特异度及DOR分别为0.63（95%置信区间（confidence interval, CI）：0.57~0.68）、0.82（95% CI：0.78~0.86）及9.18（95% CI：4.22~19.95）。此外，BS中CA153诊断BC的AUC为0.8614。
研究结论 BS中的CA153是一种具有临床应用价值的BC诊断分子标志物，若在更大规模的前瞻性研究中验证本研究结果后，可推广应用于BC筛查的标准临床实践中。