RESUMO
Many studies have shown that human telomerase activity could play potential role as a diagnostic biomarker of pancreatic cancer (PaC). The aim of this meta-analysis is to summarize the clinical value of human telomerase activity in the diagnosis of PaC. Eligible studies from PubMed, Embase, the Cochrane Library, Web of Science, Ovid, Sci Verse, Science Direct, Scopus, BioMed Central, Biosis previews, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Technology of Chongqing (VIP), and Wan Fang databases were searched concerning the diagnostic value of human telomerase activity in PaC without language restriction. The quality of each study was scored with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), and diagnostic odds ratio (DOR) for human telomerase activity in the diagnosis of PaC were pooled. Summary receiver operating characteristic (SROC) curve analysis and the area under the curve (AUC) were used to estimate the overall test performance. Evidence of heterogeneity was evaluated using the Chi-square and I (2) test. Meta-Disc 1.4 and Stata 12.0 software were used to analyze the data. Nine studies with a total 186 PaC patients and 132 control individuals were included in this meta-analysis. All of the included studies are of high quality (QUADAS score ≥10). The summary estimate was 0.83 (95 % confidence interval (CI), 95 % CI = 0.77-0.88) for sensitivity and 0.72 (95 % CI = 0.64-0.79) for specificity. The positive likelihood (PLR), negative likelihood (NLR), and diagnostic odds (DOR) ratios were 3 (95 % CI = 1.67-5.41), 0.25 (95 % CI = 0.13-0.46), and 3 (95 % CI = 4.91-43.23), respectively. The area under the summary ROC curve (AUC) and Q* index for the diagnosis of PaC were 0.88 and 0.81, respectively. Our study demonstrates that telomerase could be a useful tumor marker for PaC diagnosis. Although more studies are needed to highlight the theoretical strengths, these results will provide theoretical basis for bringing telomerase activity detection into PaC screening plan.
Assuntos
Suco Pancreático/enzimologia , Neoplasias Pancreáticas/diagnóstico , Telomerase/metabolismo , Humanos , Neoplasias Pancreáticas/enzimologia , Viés de PublicaçãoRESUMO
Measurement of telomerase activity is a promising diagnostic tool for pancreatic cancer. Detection of mRNA for human telomerase reverse transcriptase (hTERT), a catalytic subunit of telomerase, is also a diagnostic candidate. In the present study, we developed a telomeric repeat amplification protocol assay with real-time PCR and a protocol for quantification of hTERT mRNA with real-time PCR. To evaluate the feasibility of these methods for diagnosis of pancreatic cancer, we measured telomerase activity and hTERT expression in pancreatic cancer cell lines, pancreatic tissues, and pancreatic juice samples from patients with different pancreatic diseases. There were significant correlations between telomerase activity and hTERT expression in cell lines, tissues, and juice samples. The levels of telomerase activity and hTERT expression were significantly higher in tumoral tissues than in nontumoral tissues. In pancreatic juice specimens, some carcinoma samples showed remarkably high expression of hTERT. However, there were no significant differences in hTERT expression between patients with carcinoma and those with benign diseases, although significant differences in telomerase activity were observed. Our present results suggest that the combined assessment of hTERT and telomerase activities in pancreatic juice provides a potent diagnostic method for pancreatic cancer.
Assuntos
Regulação Enzimológica da Expressão Gênica , Suco Pancreático/enzimologia , Neoplasias Pancreáticas/genética , RNA Mensageiro/metabolismo , RNA Neoplásico/metabolismo , RNA/genética , Telomerase/genética , Adenocarcinoma/genética , Adenocarcinoma/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Proteínas de Ligação a DNA , Estudos de Viabilidade , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/patologia , Prognóstico , RNA/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sensibilidade e Especificidade , Telomerase/metabolismo , Células Tumorais CultivadasRESUMO
A review is presented in this paper of the available diagnostic methods for the assessment of gastrointestinal function. The techniques of gastric secretion analysis, pancreatic secretion investigation and small intestinal absorption tests are described and discussed.