Comparison of the diagnostic performance of fluorescence in situ hybridization (FISH), nuclear matrix protein 22 (NMP22), and their combination model in bladder carcinoma detection: a systematic review and meta-analysis

Background: Emerging studies reported that combination of fluorescence in situ hybridization (FISH) and nuclear matrix protein 22 (NMP22) could increase the sensitivity and specificity of bladder carcinoma (BC) management. Nevertheless, the reports remain inconsistent. This meta-analysis was undertaken to evaluate the diagnostic performance of FISH, NMP22, and their combination model in BC. Materials and methods: A systematic literature search was carried out in PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, and Wanfang database dated up to October 2018. Suitable studies were identified and raw data were extracted. Meta-analysis was conducted to calculate the global sensitivities, specificities, likelihood ratio, diagnostic odds ratio (DOR), and the areas under the summary receiver operating characteristic (SROC) curves for FISH, NMP22, and their combination model, separately. All the meta-analysis estimates were derived using STATA (version 12.0) and MetaDisc (version 1.4) software packages. Results: Seven eligible studies were included for analysis. The global sensitivities with 95% CI for FISH, NMP22, and their combination model were 0.79 (95% CI: 0.75-0.83), 0.76 (95% CI: 0.71-0.81), and 0.82 (95% CI: 0.75-0.88); specificities were 0.85 (95% CI: 0.76-0.91), 0.70 (95% CI: 0.55-0.81), and 0.90 (95% CI: 0.70-0.97); DORs were 22.215 (95% CI: 10.695-46.144), 7.365 (95% CI: 3.986-13.610), and 41.940 (95% CI: 13.546-129.853); and the areas under the SROC curves were 0.86 (95% CI: 0.82-0.88), 0.79 (95% CI: 0.76-0.83), and 0.90 (95% CI: 0.87-0.92). Conclusion: Our systematic review implied that the diagnostic performance of combination model of FISH plus NMP22 may outperform FISH or NMP22 alone in BC detection.