Diagnostic performance of minichromosome maintenance 5 (MCM5) in bladder cancer: A systematic review and meta-analysis

Primary objective of this study was to determine diagnostic accuracy of minichromosome maintenance 5 (MCM5) protein in patients with bladder cancer (BC). In this review, we searched electronic databases to identify studies on the diagnostic accuracy of MCM5 in patients with BC. We pooled sensitivity and specificities using DerSimonian-Laird random-effect analysis and followed PRISMA guidelines while conducting this review (CRD42021255609). In this meta-analysis, eight prospective studies with 5,114 patients were included. Pooled sensitivity and specificity for MCM5 in predicting BC were 0.66 (0.56-0.75) and 0.72 (0.61-0.81). Subgroup analysis of five studies with 3,000 patients using ADXBLADDER revealed sensitivity and specificity of 0.61 (0.49-0.71) and 0.67 (0.51-0.80). Pooled sensitivity and specificity for primary diagnosis of BC were 0.74 (0.64-0.82) and 0.78 (0.67-0.86), respectively. For BC surveillance, pooled sensitivity and specificity were 0.58 (0.45-0.69) and 0.61 (0.48-0.73), respectively. Pooled sensitivities for low and high-grade tumors were 0.50 (0.36-0.64) and 0.79 (0.68-0.87), respectively. Pooled specificities for low and high-grade tumors were 0.79 (0.63-0.90) and 0.82 (0.65-0.92). MCM5 has an overall moderate diagnostic accuracy for detecting BC. Subgroup analysis revealed good diagnostic performance in patients with high-grade tumors and primary diagnosis of symptomatic patients.