The diagnostic value of survivin in malignant pleural effusion: A meta-analysis

Background: Survivin in pleural effusion is a promising marker for the diagnosis of malignant pleural effusion. Methods: Based on the principles and methods of Cochrane systematic reviews, PubMed, EMBASE, Web of Knowledge (ISI), the Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases were searched to identify studies that assessed the diagnostic value of survivin in pleural effusion for malignant pleural effusion. Stata 12 and Meta-disc 1.4 software were used to test the heterogeneity and to perform the meta-analysis. Results: Our search returned 167 articles, of which ten fulfilled the inclusion criteria. These studies included a total of 614 patients with malignant pleural effusion and 430 patients with benign pleural effusion as controls. The summary assessments revealed that the pooled sensitivity was 0.86 (95% CI: 0.82-0.88) and the pooled specificity was 0.92 (95% CI: 0.89-0.94). The positive likelihood ratio was 8.76 (95% CI: 5.41-14.20), the negative likelihood ratio was 0.16 (95% CI: 0.13-0.20) and the diagnostic odds ratio (DOR) was 59.72 (95% CI: 39.60-90.05). The area under the curve (AUC) for the pleural effusion survivin tests was 0.9485, and the *Q index estimate for these tests was 0.8885. Conclusions: Survivin in pleural effusion has potential diagnostic value with advanced sensitivity and specificity and it can be used as adjunct tool for non-invasive diagnosis of malignant pleural effusion. (C) 2014 Elsevier B.V. All rights reserved.