Telomerase activity assay for the diagnosis of malignant pleural effusion: A meta-analysis

Abstract

The telomerase activity assay has been established for the detection of malignant pleural effusion (MPE), however, the overall diagnostic accuracy of the telomerase activity assay for MPE remains unclear. We performed a systematic search in the Pubmed, Embase and Cochrane databases to identify published studies that have evaluated the diagnostic role of the telomerase activity assay for MPE. Sensitivity, specificity and other measures of accuracy of the telomerase activity assay in the diagnosis of MPE were pooled using the random effects models. A summary receiver operating characteristic (SROC) curve was used to summarize overall test performance. A total of eight studies met the inclusion criteria for the meta-analysis. The pooled sensitivity and specificity for diagnosing MPE were 0.76 [95% confidence intervals (CI), 0.72–0.80] and 0.87 (95% CI, 0.83–0.91), respectively. The positive likelihood ratio was 5.19 (95% CI, 2.36–11.42), the negative likelihood ratio was 0.25 (95% CI, 0.11–0.53) and the diagnostic odds ratio was 23.18 (95% CI, 6.11–87.83). The area under the SROC curve was 0.92. The telomerase activity assay plays a role in the diagnosis of MPE with a relatively high specificity. The results of a telomerase activity assay should be interpreted together with the combination of other test results and clinical findings.

Telomerase activity analyzed with TRAP in situ provides additional information in effusions remaining equivocal after immunocytochemistry and hyaluronan analysis

“…A candidate target for such a marker is telomerase. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] Telomerase provides a mechanism for cell immortalization and plays an important role in carcinogenesis. [21][22][23] Using an in situ version of the original Telomere Repeat Amplification Protocol (TRAP) assay, 24 TRAP in situ, 25 we have previously found that telomerase is a good marker for malignancy in effusions, strong nuclear reactivity being specific for malignant cells.…”

“…A candidate target for such a marker is telomerase . Telomerase provides a mechanism for cell immortalization and plays an important role in carcinogenesis .…”