血液和尿液中的游离DNA作为膀胱癌的诊断工具：一项荟萃分析。

Cell-free DNA in blood and urine as a diagnostic tool for bladder cancer: a meta-analysis.

作者信息

Wang Xin-Shuai, Zhao Meng-Qi, Zhang Li, Kong De-Jiu, Ding Xue-Zhen, Hu Xiao-Chen, Yang Jun-Qiang, Gao She-Gan

机构信息

Henan Key Laboratory of Cancer Epigenetics; Cancer Hospital, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology Luoyang 471003, China.

出版信息

Am J Transl Res. 2018 Jul 15;10(7):1935-1948. eCollection 2018.

PMID:30093933

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6079140/

Abstract

OBJECTIVE

To assess the diagnostic performance of cell-free DNA assays in the detection of bladder cancer.

PATIENTS AND METHODS

The quality of the studies included in this meta-analysis was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Statistical analyses were performed using the software RevMan 5.3 and Stata 14.0. We assessed the pooled sensitivity and specificity, positive/negative likelihood ratios (PLRs/NLRs), diagnostic odds ratios (DORs), and corresponding 95% confidence intervals (95% CIs). Summary receiver operating characteristic curve (ROC curve) and area under the curve (AUC) were used to summarize the overall test performance. Heterogeneity and publication bias were also examined.

RESULTS

Eleven studies included 802 bladder cancer patients and 668 controls met the eligibility criteria. The overall diagnostic accuracy was measured as follows: sensitivity 0.71 (95% CI = 0.64-0.77), specificity 0.78 (95% CI = 0.70-0.85), PLR 3.3 (95% CI = 2.4-54.5), NLR 0.37 (95% CI = 0.30-0.46), DOR 9 (95% CI = 6-14), and AUC 0.80 (95% CI = 0.77-0.83). Subgroup analysis suggested that ethnicity significantly accounted for the heterogeneity of specificity. The Deeks' funnel plot asymmetry test ( = 0.97) suggested no potential publication bias.

CONCLUSIONS

Cell-free DNA has a high diagnostic value in bladder cancer.

摘要

目的

评估游离DNA检测在膀胱癌诊断中的性能。

患者与方法

使用诊断准确性研究质量评估（QUADAS-2）工具评估本荟萃分析中纳入研究的质量。采用RevMan 5.3软件和Stata 14.0软件进行统计分析。我们评估了合并敏感度和特异度、阳性/阴性似然比（PLRs/NLRs）、诊断比值比（DORs）以及相应的95%置信区间（95% CIs）。采用汇总受试者工作特征曲线（ROC曲线）和曲线下面积（AUC）总结总体检测性能。还对异质性和发表偏倚进行了检验。

结果

11项研究纳入了802例膀胱癌患者和668例对照，符合纳入标准。总体诊断准确性如下：敏感度0.71（95% CI = 0.64 - 0.77），特异度0.78（95% CI = 0.70 - 0.85），PLR 3.3（95% CI = 2.4 - 54.5），NLR 0.37（95% CI = 0.30 - 0.46），DOR 9（95% CI = 6 - 14），AUC 0.80（95% CI = 0.77 - 0.83）。亚组分析表明，种族显著影响了特异度的异质性。Deeks漏斗图不对称性检验（ = 0.97）表明无潜在发表偏倚。