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, Lindström 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.	柏建岭, 钟文昭, 郑明华, 等. Stata在Meta分析中的应用.循证医学, 2007, 7(6):363-368.
8.	周逸琴, 张杰, 郑玉平. CA153、CA199、CA125和FER在乳腺癌诊断中的价值.临床和实验医学杂志, 2014, 13(1):53-55.
9.	任媛, 王丽丽, 郑永明, 等.乳癌患者血清CA15-3、CEA、SF联检分析.放射免疫学杂志, 2001, 14(4):210.
10.	曾磊, 刘彤, 于仁波.乳癌患者血清铁蛋白测定的临床意义.放射免疫学杂志, 2001, 14(1):27-28.
11.	孙小林, 陶晓军. CA153、CEA、Fer联合检测在乳腺癌诊断中的应用.实验与检验医学, 2010, 28(4):424-426.
12.	汪覆鸣, 冷丽佳, 李晓军.多肿瘤标志物蛋白芯片检测在乳腺癌早期诊断中的价值.现代肿瘤医学, 2009, 17(6):1094-1096.
13.	叶强, 陈峻.多种肿瘤标志物在检验乳腺癌的临床应用.肿瘤基础与临床, 2009, 22(4):350-351.
14.	张纪云, 高菊兴, 董庆玉.乳腺癌患者血清β_2-MG与Fer测定的临床意义.江西医学检验, 2002, 20(2):98-99.
15.	吴莹.乳腺癌患者血清CA153、CEA、SF、CA50联检分析.放射免疫学杂志, 2002, 15(5):308-309.
16.	张金池, 陈林兴, 姚映斐, 等.血清CA15-3与CEA、SF联检对乳腺癌的诊断价值.放射免疫学杂志, 2005, 18(1):69-71.
17.	覃舒婷, 陆云飞.血清TPS、HER-2蛋白、P53抗体、SF在乳腺癌诊断上的意义.广西医科大学, 2009, 31(1):3-5.
18.	覃舒婷, 陆云飞.血清TPS、p53抗体及SF联合检测对乳腺癌的诊断价值.广西医学, 2009, 31(1):3-5.
19.	黄文海, 陈润浩, 俞建平, 等.血清肿瘤标志物检测在乳腺癌诊断中的意义.中国临床医学, 2012, 19(3):323-324.
20.	黄明德.肿瘤标志物指标在乳腺癌中的表达及临床意义分析.浙江省医学会检验医学分会、浙江省医师协会检验医师分会. 2012年浙江省检验医学学术年会论文集.浙江省医学会检验医学分会、浙江省医师协会检验医师分会, 2012, 10(32):187-188.
21.	肖静坤, 李桂彩.三种恶性肿瘤血清铁蛋白浓度及阳性率的分析.湖南医学高等专科学校学报, 2003, 5(4):42-43.
22.	高学平, 杨清默, 杨巧鹭, 等.铁蛋白及CA724在乳腺癌诊断中的应用分析.实用医学杂志, 2010, 26(22):4124-4125.
23.	洪锡田, 王景萍, 张瑞丽.血清CA153、CA125、CEA、SF检测在乳腺癌诊断中的价值.中国民康医学, 2007, 19(1):23-24.
24.	乐华帮.肿瘤标志物联合检测对乳腺癌早期诊断的意义.当代医学, 2011, 17(13):41-42.
25.	刘征宇, 温蔚.肿瘤标志物CA153、CAl25、CEA和SF联合检测对乳腺癌的诊断价值.中国基层医药, 2009, 16(11):1962-1963.
26.	胡礼仪, 陈士军, 李志沭, 等.乳腺癌患者联合检测CA15-3、CA125、CEA、SF的临床价值.中国临床医师进修杂志, 2007, 30(35):28-30.
27.	张景, 刘元明, 张薇, 等.血清铁蛋白测定对几种恶性肿瘤的诊断价值.武警医学, 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, Lindström 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. 柏建岭, 钟文昭, 郑明华, 等. Stata在Meta分析中的应用.循证医学, 2007, 7(6):363-368.
8. 周逸琴, 张杰, 郑玉平. CA153、CA199、CA125和FER在乳腺癌诊断中的价值.临床和实验医学杂志, 2014, 13(1):53-55.
9. 任媛, 王丽丽, 郑永明, 等.乳癌患者血清CA15-3、CEA、SF联检分析.放射免疫学杂志, 2001, 14(4):210.
10. 曾磊, 刘彤, 于仁波.乳癌患者血清铁蛋白测定的临床意义.放射免疫学杂志, 2001, 14(1):27-28.
11. 孙小林, 陶晓军. CA153、CEA、Fer联合检测在乳腺癌诊断中的应用.实验与检验医学, 2010, 28(4):424-426.
12. 汪覆鸣, 冷丽佳, 李晓军.多肿瘤标志物蛋白芯片检测在乳腺癌早期诊断中的价值.现代肿瘤医学, 2009, 17(6):1094-1096.
13. 叶强, 陈峻.多种肿瘤标志物在检验乳腺癌的临床应用.肿瘤基础与临床, 2009, 22(4):350-351.
14. 张纪云, 高菊兴, 董庆玉.乳腺癌患者血清β_2-MG与Fer测定的临床意义.江西医学检验, 2002, 20(2):98-99.
15. 吴莹.乳腺癌患者血清CA153、CEA、SF、CA50联检分析.放射免疫学杂志, 2002, 15(5):308-309.
16. 张金池, 陈林兴, 姚映斐, 等.血清CA15-3与CEA、SF联检对乳腺癌的诊断价值.放射免疫学杂志, 2005, 18(1):69-71.
17. 覃舒婷, 陆云飞.血清TPS、HER-2蛋白、P53抗体、SF在乳腺癌诊断上的意义.广西医科大学, 2009, 31(1):3-5.
18. 覃舒婷, 陆云飞.血清TPS、p53抗体及SF联合检测对乳腺癌的诊断价值.广西医学, 2009, 31(1):3-5.
19. 黄文海, 陈润浩, 俞建平, 等.血清肿瘤标志物检测在乳腺癌诊断中的意义.中国临床医学, 2012, 19(3):323-324.
20. 黄明德.肿瘤标志物指标在乳腺癌中的表达及临床意义分析.浙江省医学会检验医学分会、浙江省医师协会检验医师分会. 2012年浙江省检验医学学术年会论文集.浙江省医学会检验医学分会、浙江省医师协会检验医师分会, 2012, 10(32):187-188.
21. 肖静坤, 李桂彩.三种恶性肿瘤血清铁蛋白浓度及阳性率的分析.湖南医学高等专科学校学报, 2003, 5(4):42-43.
22. 高学平, 杨清默, 杨巧鹭, 等.铁蛋白及CA724在乳腺癌诊断中的应用分析.实用医学杂志, 2010, 26(22):4124-4125.
23. 洪锡田, 王景萍, 张瑞丽.血清CA153、CA125、CEA、SF检测在乳腺癌诊断中的价值.中国民康医学, 2007, 19(1):23-24.
24. 乐华帮.肿瘤标志物联合检测对乳腺癌早期诊断的意义.当代医学, 2011, 17(13):41-42.
25. 刘征宇, 温蔚.肿瘤标志物CA153、CAl25、CEA和SF联合检测对乳腺癌的诊断价值.中国基层医药, 2009, 16(11):1962-1963.
26. 胡礼仪, 陈士军, 李志沭, 等.乳腺癌患者联合检测CA15-3、CA125、CEA、SF的临床价值.中国临床医师进修杂志, 2007, 30(35):28-30.
27. 张景, 刘元明, 张薇, 等.血清铁蛋白测定对几种恶性肿瘤的诊断价值.武警医学, 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

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