Department of Oncology, the Second Affiliated Hospital of Suzhou University, Suzhou, China.
Department of Oncology, the Second People's Hospital of Changshu, Changshu, China.
PLoS One. 2020 Feb 6;15(2):e0224001. doi: 10.1371/journal.pone.0224001. eCollection 2020.
The applications of liquid biopsy have attracted much attention in biomedical research in recent years. Circulating cell-free DNA (cfDNA) in the serum may serve as a unique tumor marker in various types of cancer. Circulating tumor DNA (ctDNA) is a type of serum cfDNA found in patients with cancer and contains abundant information regarding tumor characteristics, highlighting its potential diagnostic value in the clinical setting. However, the diagnostic value of cfDNA as a biomarker, especially circulating HPV DNA (HPV cDNA) in cervical cancer remains unclear. Here, we performed a meta-analysis to evaluate the applications of HPV cDNA as a biomarker in cervical cancer. A systematic literature search was performed using PubMed, Embase, and WANFANG MED ONLINE databases up to March 18, 2019. All literature was analyzed using Meta Disc 1.4 and STATA 14.0 software. Diagnostic measures of accuracy of HPV cDNA in cervical cancer were pooled and investigated. Fifteen studies comprising 684 patients with cervical cancer met our inclusion criteria and were subjected to analysis. The pooled sensitivity and specificity were 0.27 (95% confidence interval [CI], 0.24-0.30) and 0.94(95% CI, 0.92-0.96), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 6.85 (95% CI, 3.09-15.21) and 0.60 (95% CI, 0.46-0.78), respectively. The diagnostic odds ratio was 15.25 (95% CI, 5.42-42.94), and the area under the summary receiver operating characteristic curve was 0.94 (95% CI, 0.89-0.99). There was no significant publication bias observed. In the included studies, HPV cDNA showed clear diagnostic value for diagnosing and monitoring cervical cancer. Our meta-analysis suggested that detection of HPV cDNA in patients with cervical cancer could be used as a noninvasive early dynamic biomarker of tumors, with high specificity and moderate sensitivity. Further large-scale prospective studies are required to validate the factors that may influence the accuracy of cervical cancer diagnosis and monitoring.
近年来，液体活检在生物医学研究中引起了广泛关注。血清中的循环无细胞 DNA（cfDNA）可以作为各种类型癌症的独特肿瘤标志物。循环肿瘤 DNA（ctDNA）是一种在癌症患者中发现的血清 cfDNA，包含有关肿瘤特征的丰富信息，突出了其在临床环境中的潜在诊断价值。然而，cfDNA 作为生物标志物的诊断价值，特别是宫颈癌中的循环 HPV DNA（HPV cDNA）仍然不清楚。在这里，我们进行了一项荟萃分析，以评估 HPV cDNA 作为宫颈癌生物标志物的应用。使用 PubMed、Embase 和 WANFANG MED ONLINE 数据库进行了系统的文献检索，检索时间截至 2019 年 3 月 18 日。使用 Meta Disc 1.4 和 STATA 14.0 软件对所有文献进行了分析。汇总并研究了 HPV cDNA 在宫颈癌中的诊断准确性。符合纳入标准的有 15 项研究，共纳入 684 例宫颈癌患者。汇总的敏感性和特异性分别为 0.27（95%置信区间 [CI]，0.24-0.30）和 0.94（95% CI，0.92-0.96）。汇总的阳性似然比和阴性似然比分别为 6.85（95% CI，3.09-15.21）和 0.60（95% CI，0.46-0.78）。诊断比值比为 15.25（95% CI，5.42-42.94），汇总受试者工作特征曲线下面积为 0.94（95% CI，0.89-0.99）。未观察到明显的发表偏倚。在纳入的研究中，HPV cDNA 对诊断和监测宫颈癌具有明确的诊断价值。我们的荟萃分析表明，检测宫颈癌患者的 HPV cDNA 可作为肿瘤的非侵入性早期动态生物标志物，具有高特异性和中等敏感性。需要进一步进行大规模前瞻性研究，以验证可能影响宫颈癌诊断和监测准确性的因素。
