Hyaluronic acid/ hyaluronidase as biomarkers for bladder cancer: A diagnostic meta-analysis

Abstract

This study aimed to determine the value of HA/HAase for detecting bladder cancer on the basis of preceding statistical performance. PubMed, Springer Link, Web of Science and Cochrane Library were systematically searched to identify potentially relevant published articles by using the key words: “bladder cancer or bladder tumor or bladder carcinoma”, “hyaluronic acid or hyaluronan”, “hyaluronidase or HAase”. The methodological quality of each study was assessed by QUADAS-2. According to the inclusive and exclusive criteria, 8 articles were identified and methodologically analyzed by STATA 12.0 software package. The results showed that the pooled sensitivity of HA and HAase was 0.832 (95% confidence interval [CI]: 0.798, 0.861) and 0.834 (95% CI: 0.756, 0.891) respectively, the pooled specificity was 0.886 (95% CI: 0.852, 0.913) and 0.860 (95% CI: 0.801, 0.904), and the area under the summary ROC cure (AUC) was 0.90 (95% CI: 0.87, 0.92) and 0.91 (95% CI: 0.88, 0.93), respectively. Simultaneously the diagnostic accuracy of the combination of HA and HAase showed that the pooled sensitivity was 0.908 (95% CI: 0.879, 0.931), the pooled specificity was 0.825 (95% CI: 0.789, 0.856) and AUC was 0.94 (95% CI: 0.91, 0.95), indicating a relatively higher accuracy than HA and HAase alone. This meta-analysis strongly suggests that HA/HAase could be used as biomarkers for the diagnosis of bladder cancer.