Diagnostic and prognostic value of circulating tumor DNA in gastric cancer: a meta-analysis.
Diagnostic and prognostic value of circulating tumor DNA in gastric cancer: a meta-analysis.
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胃癌循环肿瘤 DNA 的诊断和预后价值：荟萃分析。
DOI：
10.18632/oncotarget.14064
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发表时间：
2017-01-24
期刊：
影响因子：
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通讯作者：
Chen L
中科院分区：
文献类型：
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作者：
Gao Y;Zhang K;Xi H;Cai A;Wu X;Cui J;Li J;Qiao Z;Wei B;Chen L
循环肿瘤DNA（ctDNA）为胃癌（GC）的检测提供了一种微创方法。然而，其在胃癌的诊断和预后价值仍不清楚。共有16项研究，包括1193例胃癌患者符合我们的纳入标准。合并的灵敏度和特异性分别为0.62（95%置信区间（CI）0.59 - 0.65）和0.95（95% CI 0.93-0.96）。AUSROC（SROC下面积）曲线为0.94（95% CI 0.89-0.98）。结果显示，某些ctDNA标记物的存在与较大的肿瘤大小（OR：0.26，95%CI 0.11-0.61，p = 0.002）、TNM分期（I + II/III + IV，OR：0.11，95%CI 0.07 - 0.17，p = 0.000）以及H.幽门感染(H.p阴性/H.p阳性，OR：0.57，95% CI 0.36-0.91，p = 0.018）。此外，ctDNA的存在与总生存率（HR 1.77，95% CI 1.38 - 2.28，p < 0.001）以及无病生存率（HR 4.36，95% CI 3.08 - 6.16，p < 0.001）之间也存在显著相关性。检索Pubmed、Embase、科克伦图书馆和Web of Science数据库中截至2016年11月30日发表的相关文献。通过Meta-Disc软件合并诊断准确性变量。应用Engauge Digitizer和Stata软件进行预测数据提取和分析。我们的荟萃分析表明，某些ctDNA靶点的检测与GC患者的不良预后显著相关，具有高特异性和相对中等的敏感性。
Circulating tumor DNA (ctDNA) has offered a minimally invasive approach for detection and measurement of gastric cancer (GC). However, its diagnostic and prognostic value in gastric cancer still remains unclear. A total of 16 studies comprising 1193 GC patients met our inclusion criteria. The pooled sensitivity and specificity were 0.62 (95% confidence intervals (CI) 0.59−0.65) and 0.95 (95% CI 0.93–0.96), respectively. The AUSROC (area under SROC) curve was 0.94 (95% CI 0.89–0.98). The results showed that the presence of certain ctDNA markers was associated with larger tumor size (OR: 0.26, 95% CI 0.11–0.61, p = 0.002), TNM stage (I + II/III + IV, OR: 0.11, 95% CI 0.07−0.17, p = 0.000), as well as H. pylori infection. (H.p negative/H.p positive, OR: 0.57, 95% CI 0.36–0.91, p = 0.018). Moreover, there was also a significant association between the presence of ctDNA and worse overall survival (HR 1.77, 95% CI 1.38−2.28, p < 0.001), as well as disease-free survival (HR 4.36, 95% CI 3.08−6.16, p < 0.001). Pubmed, Embase, Cochrane Library and Web of Science databases were searched for relating literature published up until November 30, 2016. Diagnostic accuracy variables were pooled by the Meta-Disc software. Engauge Digitizer and Stata software were applied for prognostic data extraction and analysis. Our meta-analysis indicates the detection of certain ctDNA targets is significantly associated with poor prognosis of GC patients, with high specificity and relatively moderate sensitivity.