OBJECTIVE The aim of the study was to evaluate the diagnostic value of soluble fragment of cytokeratin 19 (CYFRA21-1) tests in detecting non-small cell lung cancer (NSCLC), including squamous cell carcinoma, lung adenocarcinoma, and large cell carcinoma. METHODS The relevant studies were identified from PubMed, Embase and the Cochrane Library before November 2018. Summary estimates for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of CYFRA21-1 tests for the diagnosis of NSCLC were calculated using the random effects model. A summary receiver operating characteristic (SROC) curve was used to assess the overall effectiveness of the test. Meta-DiSc 1.4 and Stata11.0 were applied to the statistical analysis. Publication bias was detected using Egger's test. RESULTS A total of 22 studies consisting of 7910 NSCLC patients (squamous cell carcinoma/lung adenocarcinoma/large cell carcinoma) and 2630 benign lesions patients that met the inclusion criteria were included. The meta-analysis showed that CYFRA21-1 tests had a relatively high accuracy for squamous cell carcinoma detection and a lower accuracy for lung adenocarcinoma detection. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of CYFRA21-1 tests for squamous cell carcinoma detection were 0.72 (95% confidence interval (CI) 0.70, 0.74), 0.94 (95% CI 0.92, 0.95), 9.73 (95% CI 7.06, 13.40), 0.37 (95% CI 0.29, 0.47), and 27.30 (95% CI 17.68, 42.16), respectively. The area under the SROC curve was 0.9171 (Q* = 0.8500). No publication bias was tested in the squamous cell carcinoma (P = 0.567) and lung adenocarcinoma (P = 0.378) groups. CONCLUSIONS CYFRA21-1 tests might be appropriate for detecting squamous cell carcinoma.

中文翻译：

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CYFRA21-1 测试在诊断非小细胞肺癌中的作用：一项荟萃分析。

目的：本研究旨在评估可溶性细胞角蛋白19片段（CYFRA21-1）检测在检测非小细胞肺癌（NSCLC）中的诊断价值，包括鳞状细胞癌、肺腺癌和大细胞癌。方法 相关研究在 2018 年 11 月之前从 PubMed、Embase 和 Cochrane 图书馆中确定。CYFRA21-1 检测用于诊断 NSCLC 的敏感性、特异性、阳性似然比、阴性似然比和诊断优势比的汇总估计值使用以下公式计算：随机效应模型。使用汇总接受者操作特征 (SROC) 曲线来评估测试的整体有效性。Meta-DiSc 1.4 和Stata11.0 应用于统计分析。使用 Egger 检验检测发表偏倚。结果共纳入22项研究，7910例NSCLC患者（鳞状细胞癌/肺腺癌/大细胞癌）和2630例良性病变患者符合纳入标准。荟萃分析显示，CYFRA21-1检测对鳞状细胞癌的检测准确度较高，而对肺腺癌的检测准确度较低。CYFRA21-1 检测鳞状细胞癌的总体敏感性、特异性、阳性似然比、阴性似然比和诊断优势比分别为 0.72（95% 置信区间 (CI) 0.70、0.74）、0.94（95% CI 0.92、 0.95)、9.73 (95% CI 7.06, 13.40)、0.37 (95% CI 0.29, 0.47) 和 27.30 (95% CI 17.68, 42.16)。SROC 曲线下面积为 0.9171 (Q* = 0.8500)。在鳞状细胞癌 (P = 0.567) 和肺腺癌 (P = 0.378) 组中未检测到发表偏倚。结论 CYFRA21-1 检测可能适用于检测鳞状细胞癌。