83P - Evaluation of serum macrophage inhibitory cytokine 1 as a diagnostic biomarker for pancreatic cancer: A systematic review and diagnostic accuracy meta-analysis

Background

Pancreatic cancer is one of the deadliest cancers worldwide, with a 5-year survival rate of less than 10%. The dismal prognosis is primarily due to late-stage diagnosis, resulting from the absence of specific, early, and sensitive biomarkers. Macrophage inhibitory cytokine 1 (MIC-1), a member of the transforming growth factor-beta superfamily, has been proposed as a potential biomarker for the early diagnosis of pancreatic cancer. However, the existing literature reports inconsistent diagnostic performance for serum MIC-1 levels in pancreatic cancer detection. This study aims to evaluate the diagnostic accuracy of serum MIC-1 as a biomarker for pancreatic cancer.

Methods

A systematic review was performed in PubMed, Embase, Web of Science, and Scopus to identify relevant studies published up to January 2023. These studies assessed assessing usage of MIC-1 in pancreatic cancer patients, with healthy individuals serving as the comparator control group. Statistical analysis was performed using R software (version 4.0.3) with the mada package to pool sensitivity, specificity, false-positive rate estimates, diagnostic odds ratio, and positive and negative likelihood ratios; each expressed within a 95% Confidence Interval (CI).

Results

Analysis of five studies involving 2008 participants (1151 pancreatic cancer patients, 857 healthy controls) revealed a robust diagnostic performance for serum MIC-1 levels, with a high pooled sensitivity of 86.7% (95% CI, 75.4-93.3%, I2=93.9%) and specificity of 85.9% (95% CI, 66.9-94.9%, I2=94%). A false-positive rate of 14.1% (95% CI, 5.1-33.1%) was noted. Positive and negative likelihood ratios were 6.17 (95% CI, 2.37-16.05) and 0.15 (95% CI, 0.08-0.30), respectively, and a high diagnostic odds ratio of 39.92 (95% CI, 10.44-152.66) indicated strong efficacy for MIC-1 as a diagnostic biomarker.

Conclusions

Serum MIC-1 demonstrates substantial potential as an early diagnostic biomarker for pancreatic cancer due to its high sensitivity and specificity. Nevertheless, the significant heterogeneity in the studies calls for more extensive, well-designed prospective validation studies before clinical implementation.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.