Luchini Claudio, Veronese Nicola, Nottegar Alessia, Cappelletti Vera, Daidone Maria G, Smith Lee, Parris Christopher, Brosens Lodewijk A A, Caruso Maria G, Cheng Liang, Wolfgang Christopher L, Wood Laura D, Milella Michele, Salvia Roberto, Scarpa Aldo
Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy.
National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
Cancers (Basel). 2019 Aug 10;11(8):1152. doi: 10.3390/cancers11081152.
Liquid biopsy (LB) is a non-invasive approach representing a promising tool for new precision medicine strategies for cancer treatment. However, a comprehensive analysis of its reliability for pancreatic cancer (PC) is lacking. To this aim, we performed the first meta-analysis on this topic. We calculated the pooled sensitivity, specificity, positive (LR+) and negative (LR-) likelihood ratio, and diagnostic odds ratio (DOR). A summary receiver operating characteristic curve (SROC) and area under curve (AUC) were used to evaluate the overall accuracy. We finally assessed the concordance rate of all mutations detected by multi-genes panels. Fourteen eligible studies involving 369 patients were included. The overall pooled sensitivity and specificity were 0.70 and 0.86, respectively. The LR+ was 3.85, the LR- was 0.34 and DOR was 15.84. The SROC curve with an AUC of 0.88 indicated a relatively high accuracy of LB for molecular characterization of PC. The concordance rate of all mutations detected by multi-genes panels was 31.9%. LB can serve as surrogate for tissue in the molecular profiling of PC, because of its relatively high sensitivity, specificity and accuracy. It represents a unique opportunity to be further explored towards its introduction in clinical practice and for developing new precision medicine approaches against PC.
液体活检（LB）是一种非侵入性方法，是癌症治疗新精准医学策略中一种很有前景的工具。然而，目前缺乏对其在胰腺癌（PC）诊断中可靠性的全面分析。为此，我们针对该主题进行了首次荟萃分析。我们计算了合并敏感度、特异度、阳性（LR+）和阴性（LR-）似然比以及诊断比值比（DOR）。使用汇总的受试者工作特征曲线（SROC）和曲线下面积（AUC）来评估总体准确性。我们最终评估了多基因检测板检测到的所有突变的一致率。纳入了14项涉及369例患者的符合条件的研究。总体合并敏感度和特异度分别为0.70和0.86。LR+为3.85，LR-为0.34，DOR为15.84。AUC为0.88的SROC曲线表明，LB在PC分子特征分析方面具有较高的准确性。多基因检测板检测到的所有突变的一致率为31.9%。由于LB具有相对较高的敏感度、特异度和准确性，它可以作为PC分子谱分析中组织的替代物。这代表了一个独特的机会，有待进一步探索，以便将其引入临床实践，并开发针对PC的新精准医学方法。
