Li Yang, Fu Xiao-Hong, Yuan Jin-Qiu, Yang Zu-Yao, Mao Chen, Dong Xiao-Mei, Tang Jin-Ling, Wang Sheng-Yong
Center of Injury Prevention and Control, Medical College of Jinan University, Guangzhou, China.
Expert Rev Anticancer Ther. 2015 Jun;15(6):715-25. doi: 10.1586/14737140.2015.1037836.
We performed a meta-analysis to assess whether blood can be substituted for tumor tissue in K-ras mutation testing. PubMed, EMBASE, MEDLINE, and BIOSIS databases were searched. Twenty-three studies including 1261 patients were included. The pooled overall sensitivity, specificity, and concordance rate were 0.69 (95% CI: 0.59-0.78), 0.96 (95% CI: 0.93-0.97), and 0.86 (95% CI: 0.82-0.89), respectively. Subgroup analysis indicated that plasma (sensitivity: 0.74; mutation rate: 0.34) exhibited superior sensitivity compared with serum (sensitivity: 0.45; mutation rate: 0.24). We conclude that blood is a suitable substitute for tumor tissue in K-ras mutation testing. K-ras mutation positivity in blood can be used to identify patients who should not receive EGFR monoclonal antibody therapy, but the absence of blood positivity does not necessarily imply negativity.
我们进行了一项荟萃分析，以评估在K-ras突变检测中血液是否可替代肿瘤组织。检索了PubMed、EMBASE、MEDLINE和BIOSIS数据库。纳入了23项研究，共1261例患者。汇总的总体敏感性、特异性和符合率分别为0.69（95%CI：0.59 - 0.78）、0.96（95%CI：0.93 - 0.97）和0.86（95%CI：0.82 - 0.89）。亚组分析表明，血浆（敏感性：0.74；突变率：0.34）与血清（敏感性：0.45；突变率：0.24）相比，表现出更高的敏感性。我们得出结论，在K-ras突变检测中，血液是肿瘤组织的合适替代物。血液中的K-ras突变阳性可用于识别不应接受EGFR单克隆抗体治疗的患者，但血液检测阴性并不一定意味着肿瘤组织为阴性。
