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Open Access 01-12-2020 | Fluorescence in Situ Hybridization | Research article

Diagnostic value of serum HER2 levels in breast cancer: a systematic review and meta-analysis

Authors: Amir Shamshirian, Amir Reza Aref, George W. Yip, Majid Ebrahimi Warkiani, Keyvan Heydari, Sajad Razavi Bazaz, Zeinab Hamzehgardeshi, Danial Shamshirian, Mahmood Moosazadeh, Reza Alizadeh-Navaei

Published in: BMC Cancer | Issue 1/2020

Abstract

Background

Measurement of serum human epidermal growth factor receptor-2 (HER-2/neu) levels might play an essential role as a diagnostic/screening marker for the early selection of therapeutic approaches and predict prognosis in breast cancer patients. We aimed to undertake a systematic review and meta-analysis focusing on the diagnostic/screening value of serum HER-2 levels in comparison to routine methods.

Methods

We performed a systematic search via PubMed, Scopus, Cochrane-Library, and Web of Science databases for human diagnostic studies reporting the levels of serum HER-2 in breast cancer patients, which was confirmed using the histopathological examination. Meta-analyses were carried out for sensitivity, specificity, accuracy, area under the ROC curve (AUC), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR).

Results

Fourteen studies entered into this investigation. The meta-analysis indicated the low sensitivity for serum HER2 levels (Sensitivity: 53.05, 95%CI 40.82–65.28), but reasonable specificity of 79.27 (95%CI 73.02–85.51), accuracy of 72.06 (95%CI 67.04–77.08) and AUC of 0.79 (95%CI 0.66–0.92). We also found a significant differences for PPV (PPV: 56.18, 95%CI 44.16–68.20), NPV (NPV: 76.93, 95%CI 69.56–84.31), PLR (PLR: 2.10, 95%CI 1.69–2.50) and NLR (NLR: 0.58, 95%CI 0.44–0.71).

Conclusion

Our findings revealed that although serum HER-2 levels showed low se nsitivity for breast cancer diagnosis, its specificity, accuracy and AUC were reasonable. Hence, it seems that the measurement of serum HER-2 levels can play a significant role as a verification test for initial negative screening test results, especially in low-income regions due to its cost-effectiveness and ease of implementation.

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Shamshirian A, Heydari K, Aref AR, Alizadeh-Navaei R, Shamshirian D, Hamzehgardeshi Z, Moosazadeh M. 20P - Diagnostic value of serum HER-2 level in compression with tissue HER-2 in breast cancer: A systematic review and meta-analysis. Ann Oncol. 2019;30:ix6. https://doi.org/10.1093/annonc/mdz416.019.CrossRef

Title: Diagnostic value of serum HER2 levels in breast cancer: a systematic review and meta-analysis
Authors: Amir Shamshirian
Amir Reza Aref
George W. Yip
Majid Ebrahimi Warkiani
Keyvan Heydari
Sajad Razavi Bazaz
Zeinab Hamzehgardeshi
Danial Shamshirian
Mahmood Moosazadeh
Reza Alizadeh-Navaei
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Fluorescence in Situ Hybridization
Breast Cancer
Breast Cancer
Published in: BMC Cancer / Issue 1/2020
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-020-07545-2

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