Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Int J Clin Pract. 2011 Dec;65(12):1313-20. doi: 10.1111/j.1742-1241.2011.02800.x.
An increasing number of hypermethylated genes in stool samples have been reported as biomarkers for the detection of colorectal cancer (CRC) or adenomas. We aimed to comprehensively review and compare the evidence for feasibility of using these biomarkers for the detection of colorectal neoplasia.
We searched Medline, the Web of Science and OVID for studies that used hypermethylated genes as biomarkers for the detection of CRC or adenomas. A meta-analysis was carried out using the random-effect model with diagnostic odd ratios (DOR) and 95% confidence intervals (CI) as effect measurements.
A total of 19 studies including 2,356 patients were eligible for final analysis. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and DOR for the detection of CRC or adenomas were 0.62 (95% CI: 0.51-0.71), 0.89 (95% CI: 0.86-0.92), 5.66 (95% CI: 4.68-6.83), 0.43 (95% CI: 0.34-0.55) and 13.15 (95% CI: 9.82-17.60) respectively. Of these, the sensitivity and specificity for the detection of adenoma were 0.54 (95% CI: 0.39-0.68) and 0.88 (95% CI: 0.83-0.92) respectively.
Hypermethylated gene panels are not currently accurate enough to be used alone for colorectal neoplasia screening. The discovery and evaluation of additional biomarkers with improved sensitivity and specificity is necessary.
越来越多的粪便样本中出现超甲基化基因被报道为结直肠癌（CRC）或腺瘤检测的生物标志物。我们旨在全面回顾和比较这些生物标志物用于结直肠肿瘤检测的可行性证据。
我们在 Medline、Web of Science 和 OVID 中搜索了使用超甲基化基因作为 CRC 或腺瘤检测生物标志物的研究。使用随机效应模型和诊断优势比（DOR）及 95%置信区间（CI）作为效应测量进行荟萃分析。
共有 19 项研究纳入了 2356 名患者进行最终分析。用于检测 CRC 或腺瘤的敏感性、特异性、阳性似然比、阴性似然比和 DOR 分别为 0.62（95%CI：0.51-0.71）、0.89（95%CI：0.86-0.92）、5.66（95%CI：4.68-6.83）、0.43（95%CI：0.34-0.55）和 13.15（95%CI：9.82-17.60）。其中，用于检测腺瘤的敏感性和特异性分别为 0.54（95%CI：0.39-0.68）和 0.88（95%CI：0.83-0.92）。
超甲基化基因谱目前还不够准确，不能单独用于结直肠肿瘤筛查。有必要发现和评估具有更高敏感性和特异性的其他生物标志物。
