Department of Physical Medicine and Rehabilitation, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland).
Department of Research, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland).
Med Sci Monit. 2019 Aug 5;25:5813-5822. doi: 10.12659/MSM.915472.
BACKGROUND This meta-analysis aimed to clarify the diagnostic role of plasma methylated SEPT9 (mSEPT9) in colorectal cancer (CRC) and examined its association with CRC. MATERIAL AND METHODS A systematic review was conducted prior to July 2018. Summary sensitivity, specificity, and positive and negative likelihood ratio (PLR/NLR) were calculated for the diagnostic value of mSEPT9 for CRC. The areas under the receiver operating curves (AUCs) were used to summarize the overall test performance. RESULTS Twenty-two studies with 2271 CRC patients were enrolled. The summary sensitivity, specificity, PLR, NLR, DOR, and AUC of the overall analysis of mSEPT9 were 0.69, 0.92, 8.1, 0.34, 24, and 0.89, respectively. Subgroup and meta-regression analyses demonstrated that the diagnostic value was higher for the Epi proColon 2.0 assay, Asian ethnicity, and mSEPT9 test combined with fecal occult blood test (FOBT) or fecal immunochemical test (FIT) than for other test methods, white ethnicity, and mSEPT9 test alone. The rate of mSEPT9 positivity was higher in advanced CRC cases compared with early-stage CRC cases, and was higher in CRC cases than in adenoma cases. No significant difference in mSEPT9 positivity rate was found between left- and right-sided CRC. CONCLUSIONS Plasma mSEPT9 has a high diagnostic value for CRC, especially on the newly developed Epi proColon test 2.0 method. The diagnostic sensitivity is superior among Asians compared to whites, and the combination of mSEPT9 and FOBT/FIT has a better performance than mSEPT9 alone. Finally, the expression of mSEPT9 is associated with CRC stage but not with location.
本荟萃分析旨在阐明血浆甲基化 SEPT9（mSEPT9）在结直肠癌（CRC）中的诊断作用，并研究其与 CRC 的相关性。
在 2018 年 7 月之前进行了系统评价。计算了 mSEPT9 对 CRC 的诊断价值的汇总敏感性、特异性、阳性和阴性似然比（PLR/NLR）。使用受试者工作特征曲线下的面积（AUC）来总结总体测试性能。
共纳入 22 项研究，包含 2271 例 CRC 患者。总体分析中 mSEPT9 的汇总敏感性、特异性、PLR、NLR、DOR 和 AUC 分别为 0.69、0.92、8.1、0.34、24 和 0.89。亚组和荟萃回归分析表明，Epi proColon 2.0 检测、亚洲人种以及 mSEPT9 检测联合粪便隐血试验（FOBT）或粪便免疫化学试验（FIT）的诊断价值高于其他检测方法、白种人以及 mSEPT9 单独检测。晚期 CRC 病例中 mSEPT9 阳性率高于早期 CRC 病例，并且高于腺瘤病例。左、右侧 CRC 之间的 mSEPT9 阳性率无显著差异。
血浆 mSEPT9 对 CRC 具有较高的诊断价值，特别是在新开发的 Epi proColon 2.0 检测方法上。亚洲人种的诊断敏感性优于白种人，并且 mSEPT9 联合 FOBT/FIT 的性能优于 mSEPT9 单独检测。最后，mSEPT9 的表达与 CRC 分期相关，与位置无关。
