Insulinoma-associated Protein-1 as a Biomarker for Diagnosis of Small Cell Lung Cancer: A Meta-analysis

Abstract

Objectives: Conventional pathological examination can diagnose small cell lung cancer (SCLC) relying on the combined use of multiple immunohistochemical markers, and the diagnostic accuracy still does not meet clinical needs. In recent years, insulinoma-associated protein 1 (INSM1) has gradually demonstrated its value in identifying SCLC in surgical and biopsy specimens of lung tissue. Therefore, we aimed to evaluate the diagnostic utility of INSM1 as an immunohistochemical marker in accelerating and simplifying the diagnosis of SCLC.

Methodology: PubMed, Embase and Web of Science databases were searched to retrieve literature. A meta-analysis was performed with Stata software (Stata 18.0). A random-effects model was used and subgroup analysis was carried out to identify possible sources of heterogeneity.

Results: The initial search identified 257 articles. According to the inclusion criteria, 1523 patients from 10 studies were included in this meta-analysis. The pooled sensitivity and specificity of INSM1 immunohistochemistry for the diagnosis of SCLC were 0.93 (95% CI: 0.89 – 0.96) and 0.96 (95% CI: 0.92 – 0.98), respectively. The corresponding positive likelihood ratio (PLR) was 20.84 (95% CI: 11.64 – 37.32), and the negative likelihood ratio (NLR) was 0.07 (95% CI: 0.04 – 0.12). The area under the summary receiver operating characteristic (SROC) curve was 0.98 (95% CI: 0.97 – 0.99).

Conclusions: INSM1 is a relatively promising and reliable immunohistochemical biomarker for the diagnosis of SCLC, with high sensitivity and specificity. In the future, INSM1 may be widely applied in the diagnosis of lung malignancies to improve the accuracy of pathological diagnosis for SCLC.