Diagnostic performance of micropthalmia transcription factor for melanoma: a systematic review and meta-analysis

BACKGROUND AND AIM: The diagnosis of melanoma is still a clinical challenge, many studies reported that micropthalmia transcription factor (MITF) plays a role in diagnosing melanoma, but with considerable inconsistent results. The present work aimed to summarize the overall performance of MITF in diagnosing melanoma. METHODS: A systematic literature search was performed in Pubmed and Embase for studies regarding the usefulness of MITF to diagnose melanoma. Data were retrieved and pooled sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio were determined. The post-test probability was performed to evaluate clinical usefulness. A summary receiver operator characteristic curve and the area under the curve were used to summarize the overall diagnostic accuracy. RESULTS: Nine studies with 1,299 subjects (651 melanomas and 648 non-melanomas) were included for present meta-analysis. The pooled sensitivity and specificity of MITF for diagnosing melanoma were 0.84 (95% CI: 0.81-0.87) and 0.96 (95% CI: 0.95-0.98), respectively. The positive likelihood ratio was 17.73 (95% CI: 10.85-28.99), negative likelihood ratio was 0.18 (95% CI: 0.10-0.32) and diagnostic odds ratio was 221.56 (95% CI: 66.16-741.96). In a setting of 20% prevalence of melanoma, the probability of melanoma would be 92% if the MITF test was positive, and the probability of melanoma would be 1% if it was negative. The area under the summary receiver operator characteristic curve was 0.99. CONCLUSIONS: MITF may play a valuable role in the diagnosis of melanoma with a high specificity. Nevertheless, the results of MITF should be interpreted with the combination of other test results and clinical findings.