A Panel of Serum Biomarkers (GastroPanel®) in Non-invasive Diagnosis of Atrophic Gastritis. Systematic Review and Meta-analysis

To meet the increasing demand of non-invasive tests for screening of gastric cancer (GC) risk, biomarker panel (GastroPanel®) (GP) was designed by Biohit Oyj as the first serological test for stomach health. The aim of the present study was to perform a systematic review and meta-analysis of all studies on GP in diagnosis of atrophic gastritis (AG). Studies were eligible, if i) GP was used to diagnose biopsy-confirmed AG of the corpus (AGC) and/or antrum (AGA) and ii) exact numbers were available to enable calculating sensitivity (SE) and specificity (SP). Comprehensive Meta-Analysis software was used with maximum likelihood meta-regression (R analog). Effect size estimates (SE; SP, 95% confidence interval (CI)) were tested for homogeneity with Cochran's Q and I statistics. Potential publication bias was estimated by funnel plot statistics. Altogether, 27 studies were eligible comprising of 8,654 patients from different geographic regions. Significant heterogeneity between studies reporting AGC (n=27) or AGA (n=13) warranted random effects (RE) model for summary statistics. GP performs better in diagnosing AGC than AGA with 70.2% vs. 51.6% pooled SE and 93.9% vs. 84.1% pooled SP, respectively. Limited number of studies erodes the Q test's power to detect true heterogeneity in meta-analysis stratified by geographic study origin. Few hypothetical missing studies had only marginal effect on pooled estimates of SE and SP. This first meta-analysis of GP literature corroborates the statement of international experts, advocating GP in diagnosis and screening of AG. Due to its high specificity for both AGA and AGC, GastroPanel® is truly a test for stomach health.