特异性抗体免疫组化法检测EGFR突变价值的meta分析

BACKGROUND AND OBJECTIVE: It has been proven that epidermal growth factor receptor (EGFR) mutation is the most important predictive factor for determining the effect of EGFR tyrosine kinase inhibitors (TKIs) applied to non-small cell lung cancer (NSCLC) patients. The patients with EGFR mutations response better to TKIs. To detect EGFR mutation has been particularly essential to select first-line treatment for lung cancer patients. To research and analyze the sensitivity and specificity of immunohistochemistry (IHC) using mutation specific antibodies in detecting EGFR mutations compared with DNA sequencing, and further evaluate the accuracy and clinical application value of IHC. METHODS: All required articles in Pubmed database were searched. The deadline of retrieval was March 26, 2013. Then further screening the articles based on the inclusion and exclusion criteria. Meta analysis of diagnostic test was applied to analyze the sensitivity and specificity of IHC compared with DNA sequencing for the detection of EGFR mutations. RESULTS: Ten articles were included in the meta analysis, there were 1, 679 samples in L858R group and 1, 041 samples in E746-A750del group. The DOR were 225.17 (95%CI: 55.67-910.69) and 267.16 (95%CI: 132.45-538.88) respectively; the AUC of SROC were 0.948, 4 (SEAUC=0.014, 4) and 0.981, 3 (SEAUC=0.009, 9) respectively; the Q values were 0.888, 3 (SEQ(*)=0.019, 2) and 0.939, 7 (SEQ(*)=0.019, 1) respectively. CONCLUSION: The specificity and sensitivity of IHC method using these two mutation-specific antibodies were relatively high. As a screening method for EGFR mutations, the IHC with mutation specific antibodies is of clinical value.