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血浆或血清中 EGFR 突变能否作为非小细胞肺癌的预测标志物?一项荟萃分析。

Can EGFR mutations in plasma or serum be predictive markers of non-small-cell lung cancer? A meta-analysis.

机构信息

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.

出版信息

Lung Cancer. 2015 Jun;88(3):246-53. doi: 10.1016/j.lungcan.2015.03.008. Epub 2015 Mar 17.

DOI:10.1016/j.lungcan.2015.03.008
PMID:25837799
Abstract

BACKGROUND

The detection of epidermal growth factor receptor (EGFR) mutations in plasma or serum has previously been reported to be feasible for non-small-cell lung cancer (NSCLC). However, not all results indicate a consistency between EGFR mutation status in the plasma or serum and that in tissues.

METHODS

A meta-analysis was performed to evaluate the overall accuracy of EGFR mutation detection in plasma or serum. Publications up to December 2014 were searched for using the PubMed, Embase and Web of Science databases. Sensitivity, specificity and other accuracy measures were pooled using the bivariate mixed-effects regression model.

RESULTS

Twenty-six studies were included in this meta-analysis. The pooled specificity, sensitivity, positive and negative likelihood ratios, and diagnostic odds ratios were 0.97 (95% confidence interval (CI): 0.93-0.99), 0.65 (95% CI: 0.54-0.74), 24.9 (95% CI: 9.2-67.2), 0.36 (95% CI: 0.27-0.48), and 69 (95% CI: 24-202), respectively. The summary receiver operating characteristic curve was 0.89 (95% CI: 0.86-0.91).

CONCLUSIONS

The detection of EGFR mutations in plasma or serum is a noninvasive method to confirm EGFR mutation status in patients with NSCLC. However, more work is necessary to identify which method can raise the sensitivity of EGFR mutation detection.

摘要

背景

先前已有报道称,检测血浆或血清中的表皮生长因子受体(EGFR)突变可用于非小细胞肺癌(NSCLC)。然而,并非所有结果均表明血浆或血清中的 EGFR 突变状态与组织中的状态一致。

方法

进行了一项荟萃分析,以评估血浆或血清中 EGFR 突变检测的总体准确性。使用 PubMed、Embase 和 Web of Science 数据库检索截至 2014 年 12 月的出版物。使用双变量混合效应回归模型汇总敏感性、特异性和其他准确性指标。

结果

本荟萃分析纳入了 26 项研究。汇总的特异性、敏感性、阳性似然比、阴性似然比和诊断优势比分别为 0.97(95%置信区间(CI):0.93-0.99)、0.65(95% CI:0.54-0.74)、24.9(95% CI:9.2-67.2)、0.36(95% CI:0.27-0.48)和 69(95% CI:24-202)。汇总受试者工作特征曲线为 0.89(95% CI:0.86-0.91)。

结论

检测血浆或血清中的 EGFR 突变是一种非侵入性方法,可用于确认 NSCLC 患者的 EGFR 突变状态。然而,需要进一步的工作来确定哪种方法可以提高 EGFR 突变检测的敏感性。

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