Additionally, a comprehensive analysis of its reliability issues, including its low specificity[5] and high false-positive rates in Burkitts lymphoma (BL), lymphoblastic lymphoma (LBL), and hairy cell leukemia (HCL),[5, 14, 15] has not been performed

Additionally, a comprehensive analysis of its reliability issues, including its low specificity[5] and high false-positive rates in Burkitts lymphoma (BL), lymphoblastic lymphoma (LBL), and hairy cell leukemia (HCL),[5, 14, 15] has not been performed. Accordingly, in this meta-analysis, we CACNLG evaluated the diagnostic accuracy of SOX11 immunohistochemistry for MCL. Additionally, we assessed the cause of the inconsistent specificity by comparing the specificities of different antibody clonalities and different monoclonal antibodies using subgroup analysis. Finally, meta-regression was carried out to determine the proportions of BL, LBL, and HCL, which could affect the specificity of SOX11 across different antibodies. Materials and methods Published studies and selection criteria We searched PubMed, EMBASE, and Cochrane library through May 9, 2018 with the following key words: SOX11 and (lymphoma or lymphomas). Reference lists of review articles were also searched. Duplicate data and articles were excluded considering the authors and their affiliations. Original articles were included if SOX11 immunohistochemistry was performed in human MCL and other LPD cases. When multiple articles from an author or institution were found, the most informative article was selected for the current study. Non-English articles, article or conference abstracts without sufficient information for meta-analysis, review articles, case reports, comments, errata, articles on cell lines or animals, articles with SOX11 immunohistochemistry on MCL only without other LPD, and those concerning SOX11 studies with methods other than IHC were excluded. The selection process is shown in Fig 1. Open in a separate window Fig 1 Flow diagram of study selection. Vinorelbine Tartrate Data extraction The following data from all eligible studies were extracted[5, 6, 12C23]: the first authors name, year of publication, species and clonality of the anti-SOX11 antibody, clone or catalog number of the anti-SOX11 antibody, number of SOX11-positive MCLs (true positive [TP]), number of total MCLs (number of cases), number of SOX11-positive other LPDs (false positives), number of total other LPDs (number of controls), sensitivity, specificity, and numbers of SOX11-positive and total BL, LBL, and HCL (BL+LBL+HCL positive/total). The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool was applied for quality assessment of each study.[24] QUADAS consists of 14 questions, which are scored yes (score = 1), no (score = 0), or unclear (score = 0). Statistical analyses All data were analyzed using R version 3.4.3, with the meta and mada packages.[25C27] We calculated the sensitivity and specificity, and the results were visualized on Forest plots with 95% confidence intervals (CIs). Based on random effect models, statistical heterogeneity was evaluated using Higgins statistics. In our meta-analysis, studies with values of greater than 50% were considered Vinorelbine Tartrate substantially heterogeneous. The sensitivity and specificity of each Vinorelbine Tartrate study were used to plot the summary receiver operating characteristic (SROC) curve and calculate the area under the SROC curve (AUC). Publication bias was examined by the test for funnel plot asymmetry based on a linear regression model.[28] Subgroup analysis was performed for specificity by setting the species and clonality of the antibodies and clone of the monoclonal antibodies as moderators. Meta-regression analyses were performed for specificity with proportions of BL, LBL, and HCL among other LPDs (control) as covariates in all studies for mouse monoclonal antibodies and rabbit polyclonal antibodies. Residual heterogeneity, which could not be explained by the covariate used in the meta-regression, was also considered present when values were Vinorelbine Tartrate greater than 50%. Results with values of less than 0.05 were considered as statistically significant. Results Characteristics of the studies Three hundred eighty-three reports were identified in the database search. In total, 14 studies fulfilled the inclusion criteria[5, 6, 12C23]; all were case-control studies. Two studies used more than one antibody [19, 21]. Rabbit polyclonal antibodies were used for seven study populations[5, 6, 14C17, 22]; mouse monoclonal antibodies were used for eight study populations [12, 18C21, 23]. A goat polyclonal antibody was used for one study population.[21] One study did not specify the species of antibody used.[13] Among the studies with mouse monoclonal antibodies, clone MRQ-58 was used in five study populations.[12, 18, 19,.