Division of Molecular Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Molecular Biology of Breast Cancer, Department of Gynecology and Obstetrics, University of Heidelberg Women's Hospital, Heidelberg, Germany.
Cancer Epidemiol Biomarkers Prev. 2017 Nov;26(11):1595-1602. doi: 10.1158/1055-9965.EPI-17-0502. Epub 2017 Aug 22.
Cell-free DNA integrity (cfDI) has been identified as a potential diagnostic biomarker for different types of cancer, suggesting the importance of liquid biopsy. This systematic review aims to assess the diagnostic performance of cfDI in cancer. After an extensive search of literature published through February 28, 2017, 25 articles that included 40 studies were identified. The descriptions of all the studies were analyzed. The sensitivity, specificity, positive and negative likelihood ratios, diagnostic ORs, weighted symmetric summary receiver operating characteristic curve, and the area under the curve (AUC) of cfDI in these studies were calculated. Aberrant results of cfDI were observed. Some studies observed an increased cfDI in cancer patients, while some studies confirmed a decreased cfDI compared with healthy or benign controls. This review suggests that cfDI is controversial as a blood-based biomarker of cancers, although the sensitivity and AUC were relatively high. cfDI shows heterogeneity between different studies; more perspective studies are needed to further assess its diagnostic performance, especially with other markers in combination. .
无细胞游离 DNA 完整性（cfDI）已被确定为不同类型癌症的潜在诊断生物标志物，提示液体活检的重要性。本系统评价旨在评估 cfDI 在癌症中的诊断性能。经过对截至 2017 年 2 月 28 日发表的文献进行广泛搜索，确定了 25 篇包含 40 项研究的文章。分析了所有研究的描述。计算了这些研究中 cfDI 的敏感性、特异性、阳性和阴性似然比、诊断 OR、加权对称汇总受试者工作特征曲线和曲线下面积（AUC）。观察到 cfDI 的异常结果。一些研究观察到癌症患者的 cfDI 增加，而一些研究则证实 cfDI 与健康或良性对照相比降低。本综述表明，cfDI 作为癌症的基于血液的生物标志物存在争议，尽管敏感性和 AUC 相对较高。cfDI 在不同研究之间存在异质性；需要更多的前瞻性研究来进一步评估其诊断性能，特别是与其他标志物联合使用。
