Diagnostic value of serum ICAM-1 for endometriosis A meta-analysis

Background: Previous studies have evaluated the diagnostic value of serum intercellular adhesion molecule-1 (ICAM-1) in patients with endometriosis, but the results remained inconsistent. This meta-analysis aimed to clarify the overall diagnostic accuracy of serum ICAM-1 for endometriosis. Methods: A systematic search was performed of the Cochrane clinical trials database, PubMed, and Embase prior to December 2017. Sensitivity, specificity, and other measures were pooled and determined to evaluate the accuracy of serum ICAM-1 in the diagnosis of endometriosis. Summary receiver operating characteristic curve (SROC) analysis with calculation of the area under curve (AUC) was performed to summarize the overall test performance. Results: Nine studies including 878 patients were eligible for inclusion in the analysis. The summary estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (95% confidence interval) were 0.65 (0.52-0.75), 0.78 (0.62-0.89), 3.0 (1.7-5.2), 0.45 (0.34-0.60), and 7 (3-13), respectively, and the AUC of the overall analysis was 0.76 (0.72-0.80). Subgroup analysis showed that the summary sensitivity and specificity for patients of Asian ethnicity was increased compared with those of Caucasian ethnicity. The summary specificity was increased in studies with a high ICAM-1 cut-off value compared to those with a low cut-off value. No publication bias was found across the studies. Conclusions: Our results suggest that serum ICAM-1 has moderate diagnostic accuracy for endometriosis, while the diagnostic accuracy is higher in patients of Asian ethnicity compared with those of Caucasian ethnicity.