Serum cross‐linked N‐telopeptide of type I collagen as a potential diagnostic marker for bone metastasis in lung cancer: An updated meta‐analysis

OBJECTIVE: To investigate the clinical value of serum type I collagen cross‐linked amino terminal peptide (NTx) for the diagnosis of bone metastasis in lung cancer patients by evidence‐based medicine. METHODS: Diagnostic studies relevant to NTx as a serum marker for the diagnosis of bone metastasis in lung cancer patients included in the China National Knowledge Infrastructure, Wanfang, PubMed, Embase, and VIP database from the establishment of the databases to November 2022 were retrieved. Meta‐analysis was conducted with Stata 16.0 software to calculate the combined sensitivity (SEN), specificity (SPN), positive likelihood ratio (+LR), negative likelihood ratio (−LR), diagnostic odds ratio (DOR), and its 95% confidence interval (CI). The total subject working characteristic curve (summary receiver operating characteristic (SROC) curve) was drawn, and the area under the curve was calculated to evaluate its diagnostic value. RESULTS: A total of 1742 patients with lung cancer were included in 14 articles. Meta‐analysis showed heterogeneity among the studies. The results of random‐effect model analysis demonstrated that the combined SEN, SPN, +LR, −LR, and DOR were 0.76 (95% CI 0.66–0.83), 0.80 (95% CI 0.74–0.85), 3.80 (95% CI 2.90–4.80), 0.30 (95% CI 0.22–0.42), and 12 (95% CI 8–19), respectively, and the area under SROC was 0.85. CONCLUSION: Serum NTx has a high clinical value in the diagnosis of bone metastasis in lung cancer patients and can be used as an effective complementary means for imaging diagnosis of bone metastasis in lung cancer patients.