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Insulinoma-associated protein 1(INSM1) is a superior marker for the diagnosis of gastroenteropancreatic neuroendoerine neoplasms: a meta-analysis

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Abstract

Purpose

An increasing number of studies have shown that insulinoma-associated protein 1 (INSM1) is a robust marker for the diagnosis of gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). The overall diagnostic accuracy of INSM1 for GEP-NEN remains unclear. The purpose of this study is to estimate the diagnostic value of INSM1 for GEP-NEN through a meta-analysis.

Methods

We searched relevant studies addressing the accuracy of INSM1 in the diagnosis of GEP-NEN from PubMed, Web of Science, Embase, Cochrane Library and China National Knowledge Infrastructure (CNKI) as well as from reference lists since the establishment of the database to January 12, 2021. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves were used to comprehensively evaluate the diagnostic value of INSM1 for GEP-NEN. Statistical analysis was performed by Stata 15.0 and RevMan 5.4.

Results

Nine studies with a total of 393 patients were included in the meta-analysis. The meta-analysis results showed that the pooled sensitivity and specificity of INSM1 for the diagnosis of GEP-NEN were 0.99 (95% CI: 0.87–1.00) and 0.96 (95% CI: 0.93–0.98), respectively. The PLR and NLR were 23.3 (95% CI: 13.3–40.8) and 0.01 (95% CI: 0.00–0.14), respectively. The DOR was 380.31 (95% CI: 164.14–881.21), and the area under the curve (AUC) of SROC curve was 0.98 (95% CI: 0.96–0.99).

Conclusions

The results show that INSM1 is an effective marker for the diagnosis of GEP-NEN with high sensitivity and specificity. INSM1 is recommended for clinical application to improve the diagnostic accuracy of GEP-NEN. However, more high-quality studies are needed to confirm these findings.

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Data availability

All data generated or analyzed during this study are included in this published article.

Code availability

Stata 15.0 and RevMan 5.4 were used for analyzing data. All codes used to generate the results of meta-analysis can be obtained from the authors upon request.

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Authors and Affiliations

  1. Department of Gastroenterology, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangzhou, 510220, Guangdong, China

    Qinghui Zhang, Jiahuang Huang & Jianchang Shu

  2. Department of Clinical Laboratory, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangzhou, 510220, Guangdong, China

    Yajun He

  3. Department of Emergency, Xiangyang No. 1 People’s Hospital Affiliated to Hubei University of Medicine, Xiangyang, 441000, Hubei, China

    Runze Cao

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Contributions

Q.Z., R.C., and J.H. put forward the original idea of this study and conducted a comprehensive search of the databases. Q.Z. and J.H. were responsible for study selection and data extraction. Q.Z., J.H., and Y.H. synthesized and analyzed the data and drafted the manuscript. J.S. reviewed the study and provided suggestions. All authors carefully examined this manuscript and agreed with the ideas of the research.

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Correspondence to Jianchang Shu.

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All analyses were based on previous published studies and the original data are anonymous, thus no ethical approval and patient consent are required.

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Zhang, Q., Huang, J., He, Y. et al. Insulinoma-associated protein 1(INSM1) is a superior marker for the diagnosis of gastroenteropancreatic neuroendoerine neoplasms: a meta-analysis. Endocrine 74, 61–71 (2021). https://doi.org/10.1007/s12020-021-02754-6

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