Anzeige
Erschienen in:
09.07.2022 | Review Article
KRAS Mutations in Peripheral Blood (with or without CA19-9) for Differential Diagnosis of Pancreatic Cancer and Chronic Pancreatitis: a Systematic Review and Meta-analysis
Erschienen in: Indian Journal of Surgery | Ausgabe 4/2022
Einloggen, um Zugang zu erhaltenAbstract
Differentiation between pancreatic cancer and chronic pancreatitis remains a challenge. This meta-analysis aims to explore the diagnostic value of KRAS mutations in peripheral blood [with or without carbohydrate antigen 19–9 (CA19-9)] in pancreatic cancer and chronic pancreatitis and to discern the best method for the diagnosis of pancreatic cancer.
We conducted a comprehensive search of articles indexed in the PubMed, Embase, and Web of Science databases. We not only discerned overall KRAS mutations in peripheral blood, but also evaluated and compared the diagnostic value of both KRAS mutations and CA19-9 levels.
A total of 13 studies were included in this meta-analysis. The pooled sensitivity and specificity of overall KRAS mutations in peripheral blood were 46% [95% confidence interval (CI): 29–63%] and 92% (95% CI: 86–96%), respectively. Then, we analyzed the diagnostic value of different combinations of KRAS mutations and CA19-9; ultimately, the series combinative detection of KRAS mutations and CA19-9 showed the highest diagnostic specificity, up to 98% (95% CI: 88–100%). In paralleled combinative detection of KRAS mutations and CA19-9, the diagnostic performance was significantly improved, with a sensitivity of 93% (95% CI: 84–97%) and specificity of 75% (95% CI: 53–89%).
KRAS mutations in peripheral blood have a high diagnostic value in the differential diagnosis of pancreatic cancer and chronic pancreatitis. Different combinations of CA19-9 and KRAS mutations may have variable roles in the diagnosis or screening of pancreatic cancer and have substantial potential as a tumor marker in the diagnosis of pancreatic cancer.