Diagnostic value of Telomerase Activity in patients with Bladder cancer: a meta-analysis of diagnostic test

Background: This study aimed to evaluate the diagnostic value of telomerase activity (TA) for bladder cancer (BC) by meta-analysis. Methods: We conducted a systematic search of studies published on PubMed, Embase, and Web of Science up to June 1, 2019. We used Stata 15 and Review Manager 5.3 for calculations and statistical analysis. Results: To evaluate the diagnostic value of TA for BC, we performed a meta-analysis on 22 studies, with a total of 2867 individuals, including sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR), and 95% confidence intervals (CIs). The pooled parameters were calculated from all studies and we found a sensitivity of 0.79 (95% CI: 0.72 – 0.84), a specificity of 0.91 (95% CI: 0.87–0.94), a PLR of 8.91 (95% CI: 5.91–13.43), an NLR of 0.24 (95% CI: 0.15–0.37), a DOR of 37.90 (95% CI: 23.32–61.59), and an AUC of 0.92 (95% CI: 0.90–0.94). We also conducted a subgroup analysis based on the different stages and grades of BC. Results from the subgroup analysis showed that there was no significant difference in TA in either high and low stages of BC, but that low-grade tumours had a lower TA than high-grade tumours. Conclusions: In BC, there is a high overall diagnostic value for TA, and this could provide an alternative to cystoscopy for staging and grading of tumours. The tumor characteristics also showed a good diagnostic value