Evaluation of the TMPRSS2:ERG fusion for the detection of prostate cancer: a systematic review and meta-analysis

The diagnostic value of TMPRSS2:ERG detection in patients with prostate cancer is controversial. We performed a meta-analysis to consolidate current evidence regarding the use of TMPRSS2:ERG detection assays to diagnose prostate cancers. PubMed, Web of knowledge and other databases were searched for relevant original articles published until July 30, 2013. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Studies that investigated the presence of TMPRSS2:ERG in the body fluid, needle biopsy and prostatectomy tissue of patients with prostate cancer were identified and reviewed. Sensitivities, specificities, and positive likelihood ratios (LR+) and negative likelihood ratios (LR-) of TMPRSS2:ERG detection in individual studies were calculated and meta-analyzed by random effects model. Thirty-two studies met the inclusion criteria for the meta-analysis. Overall sensitivity of TMPRSS2:ERG detection assays was 47.4 % (95 % CI, 45.5-49.3 %); specificity, LR+, and LR- was 92.6 % (95 % CI, 91.5-93.7 %), 8.94 (95 % CI, 5.65-14.13) and 0.49 (95 % CI, 0.43-0.55). The pooled sensitivity and specificity in the body fluid subgroup was 44.7 % (95 % CI, 41.5-47.9 %) and 85.8 % (95 % CI, 83.5-87.8 %), respectively. The pooled sensitivity and specificity based on the reverse transcripts PCR was 49.0 % (95 % CI, 45.9-52.1 %) and 90.2 % (95 % CI, 88.2-92.0 %), respectively. TMPRSS2:ERG may not be used as first-line screening test. However, due to the high specificity, TMPRSS2: ERG detection maybe can serve as a quick and noninvasive method for confirming prostate cancer diagnosis.