The high diagnostic accuracy of combined test of thyroid transcription factor 1 and Napsin A to distinguish between lung adenocarcinoma and squamous cell carcinoma: a meta-analysis.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Adenocarcinoma/*diagnosis ; Adenocarcinoma/*metabolism ; Aspartic Acid Endopeptidases/*metabolism ; Carcinoma, Squamous Cell/*diagnosis ; Carcinoma, Squamous Cell/*metabolism ; Immunohistochemistry/*methods ; Lung Neoplasms/*diagnosis ; Lung Neoplasms/*metabolism ; Nuclear Proteins/*metabolism ; Transcription Factors/*metabolism; Adenocarcinoma of Lung ; Diagnosis, Differential ; Humans ; Sensitivity and Specificity ; Thyroid Nuclear Factor 1

Background: Accurate classification of non-small cell lung cancer (NSCLC) using morphological features has several limitations. However, the use of thyroid transcription factor 1 (TTF-1) and Napsin A as markers for the identification of various subtypes of NSCLC has shown promise. This meta-analysis was designed to evaluate the diagnostic value of combined TTF-1 and Napsin A test to distinguish lung adenocarcinoma from squamous cell carcinoma.
Methods: The Medline, EMBASE and Web of Science databases were searched, along with the reference lists of relevant articles (up to May 4, 2014). Ten studies containing 1,446 subjects were identified. The sensitivity, specificity, diagnostic odds ratio (DOR) and area under the summary receiver operating characteristics curve (AUC) were calculated to estimate the combined diagnostic value of TTF-1 and Napsin A.
Results: The pooled sensitivity and specificity were 0.76 (95% CI: 0.69-0.83) and 1.00 (95% CI: 0.92-1.00), respectively. The positive and negative likelihood ratios were 877.60 (95% CI: 8.40-91533.40) and 0.24 (95% CI: 0.18-0.32). The DOR was 3719 (95% CI: 33-414884). The AUC was 0.92 (95%CI: 0.89-0.94). The patient's location was a source of heterogeneity for sensitivity. The patient's location, the study's sample size and the threshold used to determine positive staining were consistently found to be sources of heterogeneity for specificity in subgroup analyses and meta-regression.
Conclusions: The combined test of TTF-1 and Napsin A presents a promising alternative method, useful to distinguish between lung adenocarcinoma and squamous cell carcinoma.

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0 (NKX2-1 protein, human)
0 (Nuclear Proteins)
0 (Thyroid Nuclear Factor 1)
0 (Transcription Factors)
EC 3.4.23.- (Aspartic Acid Endopeptidases)
EC 3.4.23.- (NAPSA protein, human)

Date Created: 20140709 Date Completed: 20151105 Latest Revision: 20211021

20240829

PMC4086931

10.1371/journal.pone.0100837

25003505