Differentiation of gastric adenocarcinoma and pancreatic adenocarcinoma using immunohistochemistry biomarkers: a systematic review and meta-analysis study.

Abstract

Aim: This survey aimed to assess the differentiation of Gastric adenocarcinoma (GA) and pancreatic adenocarcinoma (PA) via immunohistochemistry biomarkers.

Background: GA and PA are two gastrointestinal malignancies with similarities in immunohistochemical features, making the diagnosis complex in some cases.

Methods: We searched international databases, including Google Scholar, Web of Science, PubMed, Embase, PROQUEST, and Cochrane Library, using appropriate keywords. The variance of each study was calculated using the binomial distribution formula, with all data analyzed by R version 16. Pooled odds ratios (OR), 95% confidence intervals (CI), and the I² test were calculated to evaluate the effectiveness of various immunohistochemistry biomarkers. Publication bias was assessed using funnel plots plus Begg's and Egger's tests.

Results: Based on the finding of our study, four potent biomarkers which can distinguish GA from PA were Cadherin 17 (CDH17) with pooled OR= 3.73 (95% CI 1.58 to 8.87), P value=0.003, and I2=55.5%; Caudal-type homeobox 2 (CDX2) with pooled OR=8.99 (95% CI 4.52 to 17.90), P value= <0.001, and I2=52.2%; CK7 with pooled OR= 0.15 (95% CI 0.04 to 0.57), P value= 0.005, and I2=56.6%; CK20 with pooled OR=2.06 (95% CI 1.38 to 3.08), P value= <0.001, and I2=0%.

Conclusion: Our study identified CDH17, COX-2, CK7, and CK20 as potent IHC biomarkers for differentiating PA and GA. Incorporating these biomarkers into routine diagnostics is essential for improving accuracy in challenging cases, ultimately aiding timely treatment decisions and improving patient outcomes.