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

Background/Aim: To meet the increasing demand of non-invasive tests for screening of gastric cancer (GC) risk, biomarker panel (GastroPanel (R)) (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). Materials and Methods: 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-2 analog). Effect size estimates (SE; SP, 95% confidence interval (CI)) were tested for homogeneity with Cochran's Q and I-2 statistics. Potential publication bias was estimated by funnel plot statistics. Results: 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. Conclusion: 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 (R) is truly a test for stomach health.