Evidence map›Paper›PMID 40614167›Full record

SynthesisCancer cytopathology2025

Diagnostic performance of SHOX2 and RASSF1A gene methylation assays in malignant pleural effusion: A systematic review and meta-analysis.

Mohamed Smail Aissani, Kyrillos Mahrous Gerges, Ahmed Msherghi, Hajer Farrara, Dawood Alatefi, Imane Chenfouh, Arwi Omar Kara, Maram Abuajamieh, Ghada Kareem, Mohammed Benhammou and 3 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cancer cytopathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Mohamed Smail AissaniFaculty of Medicine, University Blida 01, Blida, Algeria.
Kyrillos Mahrous GergesFaculty of Medicine, Sohag University, Sohag, Egypt.ORCID 0000-0002-6899-238X
Ahmed MsherghiThe University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Hajer FarraraGraduate School of Public Health and Health Policy, City University of New York, New York, New York, USA.
Dawood AlatefiUniversity of Jordan, Amman, Jordan.
Imane ChenfouhFaculty of Medicine and Pharmacy, Oujda, Oujda-Angad, Morocco.ORCID 0000-0003-2326-9101
Arwi Omar KaraFaculty of Medicine, University of Benghazi, Benghazi, Libya.
Maram AbuajamiehCairo University School of Medicine, Cairo, Egypt.
Ghada KareemDepartment of Medicine, Faculty of Medicine, Al-Qadisiyah University, Diwaniyah, Iraq.
Mohammed BenhammouFaculty of Medicine, University of Oran 1 Ahmed Ben Bella, Oran, Algeria.
Mohamed E AliCrestwood Healthcare, LP, Huntsville, Alabama, USA.
Max WintermarkThe University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Muhammed ElhadiCollege of Medicine, Korea University, Seoul, South Korea.ORCID 0000-0001-6406-4212

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalignant pleural effusion (MPE) is a common complication of advanced malignancies, requiring differentiation from benign pleural effusion for appropriate management. Cytology and biopsy have limitations, necessitating more sensitive, less invasive diagnostic techniques. The objective of this study was to evaluate the diagnostic accuracy of methylated SHOX2 (short-stature homeobox 2) and RASSF1A (Ras association domain family member 1A) genes in detecting MPE.

methodsA systematic review and meta-analysis included studies that compared benign pleural effusion and MPE cohorts using methylation of SHOX2 and RASSF1A genes in pleural fluid as the index test and cytology/histopathology as the reference standard. A random-effects model was used to calculate sensitivity, specificity, predictive values, and diagnostic odds ratios. Subgroup analysis assessed performance in lung-predominant versus nonlung-predominant MPE.

resultsFour studies with a total of 534 participants were included. The pooled sensitivity and specificity were 85% (95% confidence interval [CI], 53%-96%; heterogeneity [I

conclusionsThe combined analysis of SHOX2 and RASSF1A methylation demonstrated promising diagnostic accuracy for MPE detection, outperforming cytology. This less invasive method could reduce reliance on more invasive procedures, although further research is needed to confirm its efficacy across diverse populations and cancer types.

Indexed as

Biomarkers, TumorDNA MethylationHomeodomain ProteinsPleural Effusion, MalignantTumor Suppressor ProteinsHumansSensitivity and SpecificityBiomarkers, TumorHomeodomain ProteinsRASSF1 protein, humanSHOX2 protein, humanTumor Suppressor Proteinsdiagnostic accuracymalignant pleural effusionmethylation biomarkersRas association domain family member 1A (RASSF1A)short‐stature homeobox 2 (SHOX2)

Identifiers

PMID40614167
PMCPMC12227167

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.