Since the diagnostic accuracy of conventional examinations for malignant pleural effusion (MPE) is limited, a number of studies have investigated the utility of pleural vascular endothelial growth factor (VEGF) in the diagnosis of MPE. The present meta-analysis aimed to determine the overall accuracy of a VEGF test in the diagnosis of MPE. A systematic review of studies published in English was conducted and the data concerning the accuracy of pleural VEGF assays in the diagnosis of MPE were pooled with random effects models. The overall test performance was summarized using receiver operating characteristic curves. Ten studies, based on 1,025 patients, met the inclusion criteria for the meta-analysis and the summary estimates for VEGF in the diagnosis of MPE were: sensitivity 0.75 [95% confidence interval (CI), 0.72-0.79], specificity 0.72 (95% CI, 0.68-0.76), positive likelihood ratio 2.94 (95% CI, 1.97-4.41), negative likelihood ratio 0.38 (95% CI, 0.27-0.51) and diagnostic odds ratio 9.05 (95% CI, 4.60-17.80). The summary receiver operating characteristic curve indicated that the maximum joint sensitivity and specificity was 0.75; the area under the curve was 0.82. Our findings suggest that the determination of pleural VEGF may improve the accuracy of MPE diagnosis, while the results of VEGF assays should be interpreted in parallel with conventional test results and other clinical findings.

The -173 G/C polymorphism in the macrophage migration inhibitory factor (MIF) gene has been implicated in susceptibility to inflammatory bowel disease (IBD), but the results are inconclusive. The present meta-analysis aimed to investigate the overall association between the -173 G/C polymorphism and IBD risk. We searched in Pubmed, and Embase for studies evaluating the association between the -173G/C gene polymorphism and IBD risk. Data were extracted and statistical analysis was performed using Revman 5.1 and STATA 12.0 software. A total of seven publications involving 4729 subjects (2282 IBD cases and 2447 controls) were included in this meta-analysis. Combined analysis revealed a clear association between this polymorphism and IBD susceptibility (OR = 1.48, 95% CI: 1.10–2.00, p = 0.009 for CC vs. CG + GG). Subgroup analysis by ethnicity showed that the IBD risk associated with the -173G/C gene polymorphism was significantly elevated among Asians (OR = 1.79, 95% CI: 1.08–2.96, p = 0.02), but not among Caucasians. Subgroup analysis by disease suggested that the -173G/C gene polymorphism is a risk factor for ulcerative colitis (OR = 1.62, 95% CI: 1.10–2.37, p = 0.01), but that it was not associated with Crohn’s disease. This meta-analysis suggests that the -173 G/C polymorphism in the macrophage MIF gene contributes to IBD susceptibility, specifically in Asian populations. Further studies are needed to validate these findings.

Background: Lung cancer is a leading cause of cancer mortality, and it shows a high incidence worldwide. Circulating microRNAs have been proposed as diagnostic indicators of lung cancer, but inconsistent results in the literature have prevented their widespread use in diagnosis. The present meta-analysis aimed to systematically evaluate the diagnostic accuracy of circulating microRNAs for lung cancer. Methods: Several research databases were searched systematically for studies of the accuracy of circulating microRNAs as diagnostic indicators of lung cancer. Results from different studies were pooled using random-effects models. Summary receiver operating characteristic (SROC) curves were used to assess the overall performance of microRNA-based assays. Results: Thirteen publications were included in the meta-analysis. The following summary estimates were obtained for the performance of circulating microRNAs in lung cancer diagnosis: sensitivity, 0.85 (95% confidence intervals [CI]: 0.83–0.87); specificity, 0.84 (95% CI: 0.81–0.86); positive likelihood ratio, 5.23 (95% CI: 3.75–7.29); negative likelihood ratio, 0.20 (95% CI: 0.14–0.27); and diagnostic odds ratio, 31.77 (95% CI: 16.98–59.42). The SROC curve indicated a maximum joint sensitivity and specificity of 0.85, with an area under the curve of 0.92. Conclusion: Circulating microRNAs show significant potential as diagnostic markers of lung cancer. The results of this meta-analysis justify larger, more rigorous studies to confirm such a diagnostic role.

Airway mucus hypersecretion (AMH) is a key pathophysiological feature of chronic airway inflammatory diseases such as bronchial asthma, cystic fibrosis, and chronic obstructive pulmonary disease. AMH contributes to the pathogenesis of chronic airway inflammatory diseases, and it is associated with reduced lung function and high rates of hospitalization and mortality. It has been suggested that AMH should be a target in the treatment of chronic airway inflammatory diseases. Recent evidence suggests that a key regulator of airway inflammation, hyperresponsiveness, and remodeling is peroxisome proliferator-activated receptor gamma (PPARγ), a ligand-activated transcription factor that regulates adipocyte differentiation and lipid metabolism. PPARγis expressed in structural, immune, and inflammatory cells in the lung. PPARγis involved in mucin production, and PPARγagonists can inhibit mucin synthesis bothin vitroandin vivo. These findings suggest that PPARγis a novel target in the treatment of AMH and that further work on this transcription factor may lead to new therapies for chronic airway inflammatory diseases.

Diagnostic Value of Fluorescence in Situ Hybridization Assay in Malignant Mesothelioma: A Meta-analysis Fluorescence in situ hybridization;malignant mesothelioma;meta-analysis; The diagnosis of malignant mesothelioma (MM) remains a clinical challenge and the fluorescence in situ hybridization (FISH) assay has been reported to be one promising tool. The present meta-analysis aimed to establish the overall diagnostic accuracy of FISH for diagnosing MM. After a systematic review of English language studies, the sensitivity, specificity and other measures of accuracy of FISH in the diagnosis of MM were pooled using random-effects models. Summary receiver operating characteristic curves were applied to summarize overall test performance. Nine studies met our inclusion criteria, the pooled sensitivity and specificity for FISH for diagnosing MM being 0.72 (95% CI 0.67-0.76) and 1.00 (95% CI 0.98-1.00), respectively. The positive likelihood ratio was 34.5 (95% CI 14.5-82.10), the negative likelihood ratio was 0.24 (95% CI 0.16-0.36), and the diagnostic odds ratio was 204.9 (95% CI 76.8-546.6), the area under the curve being 0.99. Our data suggest that the FISH assay is likely to be a useful diagnostic tool for confirming MM. However, considering the limited studies and patients included, further large scale studies are needed to confirm these findings.