Diagnostic accuracy of SHOX-2 methylation for malignant pleural effusion: a systematic review and meta-analysis.

Abstract

<h4>Background</h4>Some studies have assessed the diagnostic value of SHOX-2 methylation for malignant pleural effusion (MPE), but their findings were inconsistent. This study aimed to conduct a systematic review and meta-analysis to evaluate the diagnostic accuracy of SHOX-2 methylation for MPE.<h4>Methods</h4>We searched the PubMed and Web of Science databases to identify studies involving SHOX-2 methylation in diagnosing MPE. The last search date was in December 2024. We evaluated the quality of the included studies using the revised Quality Assessment of Diagnostic Accuracy Studies tool-2 (QUADAS-2). A bivariate model was used to pool the sensitivity, specificity, and their 95% confidence intervals (CIs) of SHOX-2 methylation. The overall diagnostic accuracy of SHOX-2 methylation was assessed by a summary receiver operating characteristic (sROC) curve. The publication bias was analyzed using Deek's test.<h4>Results</h4>Six studies with 613 MPE patients and 723 benign pleural effusion (BPE) patients were included. The pooled sensitivity (95% CI) and specificity (95% CI) of SHOX-2 methylation were 0.64 (0.36-0.85) and 0.96 (0.92-0.98), respectively. The area under the sROC curve was 0.96 (95% CI: 0.94-0.97). There was no publication bias across the eligible studies.<h4>Conclusions</h4>SHOX-2 methylation has a moderate diagnostic value for MPE.