Accuracy of Serum Ferritin for Breast Cancer: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 WUYao-zhong ,  LILi-qun , HUANGChao , RAOBin , DONGAn-hui

Department of General Surgery, Red Cross Hospital of Wuzhou City, Wuzhou 543000, China;

Corresponding?author：

LILi-qun, Email: 2215713788@qq.com

Keywords：

Serum ferritin; Breast cancer; Systematic review; Meta-analysis; Diagnostic test

DOI：

10.7507/1672-2531.20140233

Video：

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Objective To systematically review the accuracy of serum ferritin (SF) for detecting breast cancer. Methods We electronically and comprehensively searched databases including CNKI, WanFang Data, CBM, VIP, PubMed, EMbase and The Cochrane Library (Issue 5, 2013) up to April 2013, for diagnostic tests about using SF for detecting breast cancer. Four reviewers independently screened literature according to the exclusion and inclusion criteria, extracted data, and assessed methodological quality of included studies. Then, meta-analysis was performed using Meta-Disc 1.4 software and funnel plots were drawn using Stata 12.0 software. Results A total of 19 studies were finally included involving 2 977 patients. The results of meta-analysis showed that:Sen, Spe, +LR, -LR, DOR were 0.51 (95%CI 0.48 to 0.53), 0.91 (95%CI 0.89 to 0.92), 5.32 (95%CI 3.72 to 7.60), 0.45 (95%CI 0.35 to 0.57), and 13.22 (95%CI 7.22 to 24.18); SROC area under the curve (AUC) was 0.920 5 and Q^* was 0.853 9. Besides, when cut off value was 101-150 μg/L, Sen, Spe, AUC and Q^* were the largest, and the best cut-off value was probably 150 μg/L. Conclusion SF has relatively high Sen and Spe in the diagnosis of breast cancer which could not be used as specific index. Heterogeneities exist among the research results, which are possibly associated with researchers, severity of disease, instrument types, sources of reagents, and cut off values. Due to limited quality and quantity of the included studies, the above conclusion should be treated with caution, and in clinic, combing other tumour markers with SF is recommended in detecting breast cancer to augment accuracy.

Citation： WUYao-zhong, LILi-qun, HUANGChao, RAOBin, DONGAn-hui. Accuracy of Serum Ferritin for Breast Cancer: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(12): 1450-1458. doi: 10.7507/1672-2531.20140233 Copy

1.	Shpyleva SI, Tryndyak VP, Kovalchuk O, et al. Role of ferritin alterations in human breast cancer cells. Breast Cancer Res Treat, 2011, 126(1):63-71.
2.	Alkhateeb AA, Han B, Connor JR. Ferritin stimulates breast cancer cells through an iron-independent mechanism and is localized within tumor-associated macrophages. Breast Cancer Res Treat, 2013, 137(3):733-744.
3.	Orlandi R, De Bortoli M, Ciniselli CM, et al. Hepcidin and ferritin blood level as noninvasive tools for predicting breast cancer. Ann Oncol, 2014, 25(2):352-357.
4.	Monti M, Catania S, Locatelli E, et al. Axillary versus peripheral blood levels of sialic acid, ferritin, and CEA in patients with breast cancer. Breast Cancer Res Treat, 1990, 17(2):77-82.
5.	Graff RE, Cho E, Lindstr?m S, et al. Premenopausal plasma ferritin levels, HFE polymorphisms, and risk of breast cancer in the nurses'health study Ⅱ. Cancer Epidemiol Biomarkers Prev, 2014, 23(3):516-524.
6.	Whiting PF, Weswood ME, Rutjes AW, et al. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol, 2006, 17(6):9.
7.	柏建嶺, 鐘文昭, 鄭明華, 等. Stata在Meta分析中的應用.循證醫學, 2007, 7(6):363-368.
8.	周逸琴, 張杰, 鄭玉平. CA153、CA199、CA125和FER在乳腺癌診斷中的價值.臨床和實驗醫學雜志, 2014, 13(1):53-55.
9.	任媛, 王麗麗, 鄭永明, 等.乳癌患者血清CA15-3、CEA、SF聯檢分析.放射免疫學雜志, 2001, 14(4):210.
10.	曾磊, 劉彤, 于仁波.乳癌患者血清鐵蛋白測定的臨床意義.放射免疫學雜志, 2001, 14(1):27-28.
11.	孫小林, 陶曉軍. CA153、CEA、Fer聯合檢測在乳腺癌診斷中的應用.實驗與檢驗醫學, 2010, 28(4):424-426.
12.	汪覆鳴, 冷麗佳, 李曉軍.多腫瘤標志物蛋白芯片檢測在乳腺癌早期診斷中的價值.現代腫瘤醫學, 2009, 17(6):1094-1096.
13.	葉強, 陳峻.多種腫瘤標志物在檢驗乳腺癌的臨床應用.腫瘤基礎與臨床, 2009, 22(4):350-351.
14.	張紀云, 高菊興, 董慶玉.乳腺癌患者血清β_2-MG與Fer測定的臨床意義.江西醫學檢驗, 2002, 20(2):98-99.
15.	吳瑩.乳腺癌患者血清CA153、CEA、SF、CA50聯檢分析.放射免疫學雜志, 2002, 15(5):308-309.
16.	張金池, 陳林興, 姚映斐, 等.血清CA15-3與CEA、SF聯檢對乳腺癌的診斷價值.放射免疫學雜志, 2005, 18(1):69-71.
17.	覃舒婷, 陸云飛.血清TPS、HER-2蛋白、P53抗體、SF在乳腺癌診斷上的意義.廣西醫科大學, 2009, 31(1):3-5.
18.	覃舒婷, 陸云飛.血清TPS、p53抗體及SF聯合檢測對乳腺癌的診斷價值.廣西醫學, 2009, 31(1):3-5.
19.	黃文海, 陳潤浩, 俞建平, 等.血清腫瘤標志物檢測在乳腺癌診斷中的意義.中國臨床醫學, 2012, 19(3):323-324.
20.	黃明德.腫瘤標志物指標在乳腺癌中的表達及臨床意義分析.浙江省醫學會檢驗醫學分會、浙江省醫師協會檢驗醫師分會. 2012年浙江省檢驗醫學學術年會論文集.浙江省醫學會檢驗醫學分會、浙江省醫師協會檢驗醫師分會, 2012, 10(32):187-188.
21.	肖靜坤, 李桂彩.三種惡性腫瘤血清鐵蛋白濃度及陽性率的分析.湖南醫學高等專科學校學報, 2003, 5(4):42-43.
22.	高學平, 楊清默, 楊巧鷺, 等.鐵蛋白及CA724在乳腺癌診斷中的應用分析.實用醫學雜志, 2010, 26(22):4124-4125.
23.	洪錫田, 王景萍, 張瑞麗.血清CA153、CA125、CEA、SF檢測在乳腺癌診斷中的價值.中國民康醫學, 2007, 19(1):23-24.
24.	樂華幫.腫瘤標志物聯合檢測對乳腺癌早期診斷的意義.當代醫學, 2011, 17(13):41-42.
25.	劉征宇, 溫蔚.腫瘤標志物CA153、CAl25、CEA和SF聯合檢測對乳腺癌的診斷價值.中國基層醫藥, 2009, 16(11):1962-1963.
26.	胡禮儀, 陳士軍, 李志沭, 等.乳腺癌患者聯合檢測CA15-3、CA125、CEA、SF的臨床價值.中國臨床醫師進修雜志, 2007, 30(35):28-30.
27.	張景, 劉元明, 張薇, 等.血清鐵蛋白測定對幾種惡性腫瘤的診斷價值.武警醫學, 2007, 18(1):74-75.
28.	Kokocińska D, Widala E, Donocik J, et al. The value of evaluating tumor markers:CA 15-3 and ferritin in blood serum of patients grouped as "high risk" for breast cancer. Przegl Lek, 1999, 56(10):664-667.

1. Shpyleva SI, Tryndyak VP, Kovalchuk O, et al. Role of ferritin alterations in human breast cancer cells. Breast Cancer Res Treat, 2011, 126(1):63-71.
2. Alkhateeb AA, Han B, Connor JR. Ferritin stimulates breast cancer cells through an iron-independent mechanism and is localized within tumor-associated macrophages. Breast Cancer Res Treat, 2013, 137(3):733-744.
3. Orlandi R, De Bortoli M, Ciniselli CM, et al. Hepcidin and ferritin blood level as noninvasive tools for predicting breast cancer. Ann Oncol, 2014, 25(2):352-357.
4. Monti M, Catania S, Locatelli E, et al. Axillary versus peripheral blood levels of sialic acid, ferritin, and CEA in patients with breast cancer. Breast Cancer Res Treat, 1990, 17(2):77-82.
5. Graff RE, Cho E, Lindstr?m S, et al. Premenopausal plasma ferritin levels, HFE polymorphisms, and risk of breast cancer in the nurses'health study Ⅱ. Cancer Epidemiol Biomarkers Prev, 2014, 23(3):516-524.
6. Whiting PF, Weswood ME, Rutjes AW, et al. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol, 2006, 17(6):9.
7. 柏建嶺, 鐘文昭, 鄭明華, 等. Stata在Meta分析中的應用.循證醫學, 2007, 7(6):363-368.
8. 周逸琴, 張杰, 鄭玉平. CA153、CA199、CA125和FER在乳腺癌診斷中的價值.臨床和實驗醫學雜志, 2014, 13(1):53-55.
9. 任媛, 王麗麗, 鄭永明, 等.乳癌患者血清CA15-3、CEA、SF聯檢分析.放射免疫學雜志, 2001, 14(4):210.
10. 曾磊, 劉彤, 于仁波.乳癌患者血清鐵蛋白測定的臨床意義.放射免疫學雜志, 2001, 14(1):27-28.
11. 孫小林, 陶曉軍. CA153、CEA、Fer聯合檢測在乳腺癌診斷中的應用.實驗與檢驗醫學, 2010, 28(4):424-426.
12. 汪覆鳴, 冷麗佳, 李曉軍.多腫瘤標志物蛋白芯片檢測在乳腺癌早期診斷中的價值.現代腫瘤醫學, 2009, 17(6):1094-1096.
13. 葉強, 陳峻.多種腫瘤標志物在檢驗乳腺癌的臨床應用.腫瘤基礎與臨床, 2009, 22(4):350-351.
14. 張紀云, 高菊興, 董慶玉.乳腺癌患者血清β_2-MG與Fer測定的臨床意義.江西醫學檢驗, 2002, 20(2):98-99.
15. 吳瑩.乳腺癌患者血清CA153、CEA、SF、CA50聯檢分析.放射免疫學雜志, 2002, 15(5):308-309.
16. 張金池, 陳林興, 姚映斐, 等.血清CA15-3與CEA、SF聯檢對乳腺癌的診斷價值.放射免疫學雜志, 2005, 18(1):69-71.
17. 覃舒婷, 陸云飛.血清TPS、HER-2蛋白、P53抗體、SF在乳腺癌診斷上的意義.廣西醫科大學, 2009, 31(1):3-5.
18. 覃舒婷, 陸云飛.血清TPS、p53抗體及SF聯合檢測對乳腺癌的診斷價值.廣西醫學, 2009, 31(1):3-5.
19. 黃文海, 陳潤浩, 俞建平, 等.血清腫瘤標志物檢測在乳腺癌診斷中的意義.中國臨床醫學, 2012, 19(3):323-324.
20. 黃明德.腫瘤標志物指標在乳腺癌中的表達及臨床意義分析.浙江省醫學會檢驗醫學分會、浙江省醫師協會檢驗醫師分會. 2012年浙江省檢驗醫學學術年會論文集.浙江省醫學會檢驗醫學分會、浙江省醫師協會檢驗醫師分會, 2012, 10(32):187-188.
21. 肖靜坤, 李桂彩.三種惡性腫瘤血清鐵蛋白濃度及陽性率的分析.湖南醫學高等專科學校學報, 2003, 5(4):42-43.
22. 高學平, 楊清默, 楊巧鷺, 等.鐵蛋白及CA724在乳腺癌診斷中的應用分析.實用醫學雜志, 2010, 26(22):4124-4125.
23. 洪錫田, 王景萍, 張瑞麗.血清CA153、CA125、CEA、SF檢測在乳腺癌診斷中的價值.中國民康醫學, 2007, 19(1):23-24.
24. 樂華幫.腫瘤標志物聯合檢測對乳腺癌早期診斷的意義.當代醫學, 2011, 17(13):41-42.
25. 劉征宇, 溫蔚.腫瘤標志物CA153、CAl25、CEA和SF聯合檢測對乳腺癌的診斷價值.中國基層醫藥, 2009, 16(11):1962-1963.
26. 胡禮儀, 陳士軍, 李志沭, 等.乳腺癌患者聯合檢測CA15-3、CA125、CEA、SF的臨床價值.中國臨床醫師進修雜志, 2007, 30(35):28-30.
27. 張景, 劉元明, 張薇, 等.血清鐵蛋白測定對幾種惡性腫瘤的診斷價值.武警醫學, 2007, 18(1):74-75.
28. Kokocińska D, Widala E, Donocik J, et al. The value of evaluating tumor markers:CA 15-3 and ferritin in blood serum of patients grouped as "high risk" for breast cancer. Przegl Lek, 1999, 56(10):664-667.

Chinese Journal of Evidence-Based Medicine

Accuracy of Serum Ferritin for Breast Cancer: A Meta-Analysis

Abstract Full text Figures/Tables Video References Cited by

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