The diagnostic value of NR4A3/NOR1 for acinic cell caicinoma:a Meta-analysis

ZHANG Zhaoxia; YU Yuanhui; ZHANG Xiaoqin; CHEN Zhenwen; XU Yirong

Abstract：Objective:To analyze and evaluate the value of NR4A3/NOR1 for the diagnosis of acinic cell caicinoma(AciCC).Methods:A comprehensive literature search of PubMed,Cochrane Library,EMBase,CNKI,VIP,CBM and Wanfang(up to February 1,2024)was performed to identify eligible studies.Quality assessment of included literature was performed independently by two reviewers using Review Manager 5.3(Cochrane Collaboration Group).Stata/SE15.1 and Meta-Disc1.4 software were used for meta-analysis.The pooled sensitivity,pooled specificity,pooled positive likelihood ratio,pooled negative likelihood ratio,and pooled diagnostic odds ratio(DOR)were calculated;the summary receiver operating characteristic(SROC)curve was plotted,and the area under the curve(AUC)was calcu-lated.Moreover,Meta-regression analyses were performed to determine the source of heterogeneity.Deek's funnel plot test was used to assess publication bias.Sensitivity analysis was conducted on the literature included in this study using a bivariate mixed effects model.Likelihood ratio matrix,pre-test probability and post-test probability to evaluate its clinical applicability.Results:This study included a total of 488 AciCC patients and 1 220 controls.Meta-analysis re-sults showed that the pooled sensitivity,specificity,and DOR of NR4A3/NOR1 for the diagnosis of AciCC were 0.95(95%CI 0.92～0.97),0.99(95%CI 0.98～1.00)and 7.90(95%CI 6.65～9.15),respectively,and the AUC of the SROC was 0.99.Slight heterogeneity was observed in sensitivity(I2=42.26%),and subgroup analysis and metare-gression showed that heterogeneity is related to the source of the specimen and the number of cases.Fagan pre-test probability was 29%,positive likelihood ratio was 134,positive post-test probability was 98%,negative likelihood ratio was 0.05,negative post-test probability was 2%.Conclusion:NR4A3/NOR1 is a potential biomarker for the diagnosis of AciCC with a high sensitivity and specificity,but other clinical indicators need to be referred to in application.