Department of the Third general surgery, The Fourth Affiliated Hospital of the China Medical University, No. 4 Chongshan Road, Shenyang, 110032, China.
Shenyang Anorectal Hospital, No. 9 North of Nanjing Street, Heping District, Shenyang, 110000, China.
Pathol Oncol Res. 2019 Oct;25(4):1525-1534. doi: 10.1007/s12253-018-0559-5. Epub 2018 Nov 28.
This meta-analysis aimed to assess the diagnostic efficiency of blood-based septin 9 (SEPT9) methylation assay for the detection of colorectal cancer (CRC). Studies were searched in the Springer, Wiley, Cochrane Library, PubMed, Ovid, Embase, Web of Science, China BioMedicine, Wanfang and China National Knowledge Infrastructure databases until July 2017. Methodological quality assessment was performed based on the guidelines of the Quality Assessment of Diagnostic Accuracy Studies. According to 1/3 and 2/3 algorithms, the meta-analyses for the diagnostic effect of SEPT9 in CRC were compared with healthy subjects and subjects with polyps, adenoma, and non-CRC, respectively. The random effects model was applied and publication bias was evaluated. The included 29 studies comprised 10,486 subjects (3202 patients with CRC and 7284 controls). In comparison with healthy subjects, the pooled sensitivity with 95% confidence intervals (CIs) of SEPT9 methylation for the diagnosis of CRC was 0.74 (95% CI: 0.61-0.84) in the 1/3 algorithm group, whereas the specificity was 0.96 (95% CI: 0.95-0.97) in the 2/3 algorithm group. Additionally, positive likelihood ratio was less than 10 and negative likelihood ratio more than 0.1 in the 2/3 algorithm group for patients with CRC vs. polyps and adenoma. The P value of Deeks' funnel plot was 0.36, suggesting that there was no publication bias. SEPT9 methylation can be used to diagnose CRC in healthy individuals under the 2/3 algorithm. The determination of SEPT9 methylation does not distinguish well between CRC and polyps or adenoma.
本荟萃分析旨在评估基于血液的 Septin9（SEPT9）甲基化检测在结直肠癌（CRC）检测中的诊断效率。检索 Springer、Wiley、Cochrane Library、PubMed、Ovid、Embase、Web of Science、中国生物医学文献数据库、万方和中国国家知识基础设施数据库，截至 2017 年 7 月。根据诊断准确性研究质量评估指南进行方法学质量评估。根据 1/3 和 2/3 算法，比较了 SEPT9 在 CRC 与健康对照和息肉、腺瘤以及非 CRC 患者中的诊断效果。应用随机效应模型评估发表偏倚。纳入的 29 项研究共纳入 10486 例患者（3202 例 CRC 患者和 7284 例对照）。与健康对照相比，1/3 算法组中 SEPT9 甲基化用于 CRC 诊断的合并敏感度为 0.74（95%CI：0.61-0.84），而 2/3 算法组中特异度为 0.96（95%CI：0.95-0.97）。此外，在 2/3 算法组中，CRC 患者与息肉和腺瘤患者相比，阳性似然比小于 10，阴性似然比大于 0.1。Deeks 漏斗图的 P 值为 0.36，表明无发表偏倚。在 2/3 算法下，SEPT9 甲基化可用于健康个体诊断 CRC。SEPT9 甲基化对 CRC 和息肉或腺瘤的区分效果不佳。
