CA125 for the Diagnosis of Advanced Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-Analysis

SIMPLE SUMMARY: Urothelial carcinoma of the bladder (UCB) is a common genitourinary cancer. Advanced UCB, defined as muscle-invasive and lymph node-involving, is linked to poor outcomes. CA125 is a well-known tumor marker for ovarian cancer and can be used as a diagnostic marker for advanced UCB. This meta-analysis reviewed published studies in English and Chinese on serum CA125 for advanced UCB. One thousand five hundred seventy patients from 14 studies were analyzed. The diagnostic odds ratio was 8.138, and the area under the receiver operating characteristic curve was 0.797. Serum CA125 may help distinguish advanced UCB from non-advanced UCB patients. CA125 may help clinicians plan the treatment of UCB. ABSTRACT: Background: Urothelial carcinoma of the bladder (UCB) is the second most common genitourinary cancer. This study aims to assess the diagnostic accuracy of CA125 in advanced UCB. Methods: We searched prevalent studies in PubMed, the Cochrane Library, Scopus, Embase, the Web of Science China National Knowledge Infrastructure database, and Wanfang data before October 2022. Pooled sensitivity, specificity, and summary receiver operating characteristics were used to assess the diagnostic value of CA125. Results: One thousand six hundred forty-one patients from 14 studies were analyzed. UCB stage T3–4N1 was defined as advanced UCB in ten studies; T2–4 was used in three studies; and N1M1 in one study. Patients’ age was between 21 to 92, and 21% to 48.6% of patients were female. The pooled sensitivity was 0.695 (95% confidence interval (CI): 0.426–0.875). The pooled specificity was 0.846 (95% CI: 0.713–0.924). The diagnostic odds ratio was 8.138 (95% CI: 4.559–14.526). The AUC was 0.797. Conclusion: CA125 may provide significant diagnostic accuracy in identifying muscle-invasive, lymph node-involved, and distant metastatic tumors in patients with urothelial carcinoma of the bladder. Limited studies have been conducted on the prognostic role of CA125. More studies are needed for a meta-analysis on the prognostic role of CA125 in UCB.