Abstract
BACKGROUND: There have been many reports on midkine as a promising marker in the diagnosis of hepatocellular carcinoma (HCC). However, the results are inconsistent and even conflicting. METHODS: This meta-analysis was performed to investigate the accuracy of midkine in the diagnosis of HCC. Meta-DiSc 1.4 software was used to extract data and to calculate the overall sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Data are presented as forest plots and summary receiver operating characteristic (SROC) curve analysis was used to summarize the overall test performance. RESULTS: Ten studies with a total of 753 HCC patients and 977 non-HCC patients were included. The overall pooled diagnostic data were as follows: the pooled sensitivity of 0.86 (95% confidence interval [CI]: 083-0.88), the pooled specificity of 0.75 (95% CI: 0.73-0.78), the pooled PLR of 4.71 (95% CI: 2.80-7.90), the pooled NLR of 0.18 (95% CI: 0.11-0.30), and the pooled DOR of 36.83 (95% CI: 13.56-100.05). The area under curve value was 0.9266 in the overall SROC curve. CONCLUSION: Midkine has moderate diagnostic accuracy for HCC. Due to the design limitations, results inpublished studies should be carefully interpreted. In addition, more well-designed studies with large sample sizes should be performed to rigorously evaluate the diagnostic accuracy of the MDK.