Table 2.
Summary estimates for the results from subgroup analyses depending on cancer type, cancer stage, control type used, and DKK-1 used alone or in combination for the diagnosis of GIC.
| No. of Studies (Analyses) | No. of participants (there is duplication) | Sensitivity (95% CI) |
Specificity (95% CI) |
Positive Likelihood Ratio (95% CI) |
Negative Likelihood Ratio (95% CI) |
Diagnostic Odds Ratio (95% CI) |
Area Under the Curve |
Mete-regression | Publication bias | GRADE | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| DKK-1 used alone | |||||||||||
| Overall | 31 (52) | 11718 | 0.70 (0.69-0.71) | 0.82 (0.81-0.83) | 4.59 (3.50-6.01) | 0.34 (0.29-0.39) | 14.49 (9.72-21.60) |
0.8365 | 0.06 | 0.893 | High |
| HCC | 17 (35) | 9080 | 0.71 (0.69-0.72) | 0.87 (0.86-0.88) | 5.12 (4.08-6.41) | 0.33 (0.29-0.37) |
17.08 (12.83-22.74) | 0.8515 | 0.208 | High | |
| Compared with LC±HBV±HCV in HCC | 7 (16) | 3964 | 0.71 (0.68-0.73) | 0.86 (0.84-0.87) | 4.79 (3.77-6.09) | 0.34 (0.30-0.39) | 14.98 (10.73-20.92) | 0.8201 | 0.36 | 0.755 | High |
| Early HCC | 5 (11) | 2885 | 0.73 (0.70-0.76) | 0.90 (0.88-0.91) | 6.17 (4.16-9.16) | 0.31 (0.28-0.35) | 22.14 (13.96-35.09) | 0.8258 | 0.61 | 0.688 | High |
| PC | 6 (9) | 1386 | 0.72 (0.69-0.75) | 0.73 (0.70-0.76) | 4.16 (2.15-8.04) | 0.23 (0.12-0.45) | 19.78 (5.35-73.08) | 0.8818 | 0.712 | Moderate | |
| Early PC | 1 (2) | 154 | 0.85 (0.78-0.91) | 0.77 (0.69-0.84) | 3.69 (2.69-5.07) | 0.19 (0.12-0.30) | 19.23 (10.07-36.72) | - | 0.28 | - | Low |
| GC+EPC | 6 (6) | 1079 | 0.65 (0.61-0.69) | 0.53 (0.49-0.57) | 3.53 (1.15-10.88) | 7.67 (3.93-14.95) | 0.09 (0.04-0.19) | 0.7358 | 0.289 | Moderate | |
| DKK-1 in combination with other tumour marker | |||||||||||
| DKK-1+AFP | |||||||||||
| HCC | 12 (30) | 7683 | 0.91 (0.82-0.96) | 0.88 (0.87-0.89) | 6.39 (5.26-7.77) | 0.19 (0.16-0.23) | 36.57 (26.30-50.86) | 0.9211* | 0.945 | High | |
| Compared with LC±HBV±HCV in HCC | 5 (12) | 2654 | 0.80 (0.78-0.82) | 0.82 (0.79-0.84) | 4.36 (3.69-5.17) | 0.23 (0.17-0.29) | 20.26 (14.22-28.87) | 0.8876 | 0.09 | 0.582 | High |
| Early HCC | 5 (13) | 3138 | 0.84 (0.82-086) | 0.87 (0.85-0.88) | 5.56 (4.20-7.37) | 0.19 (0.14-0.26) | 30.33 (18.37-50.09) | 0.9109* | 0.47 | 0.524 | High |
| DKK-1+CA19-9 | |||||||||||
| PC | 4 (7) | 1109 | 0.96 (0.94-0.97) | 0.72 (0.68-0.76) | 3.70 (2.55-5.36) | 0.06 (0.04-0.11) | 80.46 (46.37-139.6) | 0.9563* | 0.881 | High | |
| Early PC | 1 (2) | 250 | 0.98 (0.94-1.00) | 0.67 (0.58-0.75) | 2.92 (2.26-3.76) | 0.02 (0.01-0.09) | 134.55 (31.18-580.67) | 0.500 | 0.58 | - | Moderate |
AEGJ, adenocarcinoma of oesophagogastric junction; CRC, colorectal carcinoma; DKK-1, dickkopf-1; ELISA, enzyme-linked immunosorbent assay; EPC, oesophageal carcinoma; GIC, gastrointestinal carcinomas; HCC, hepatocellular carcinoma; IHC, immunohistochemistry; IHCC, intrahepatic cholangiocarcinoma; LC, liver carcinomas; PC, pancreatic carcinomas, *high diagnostic value.