Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Cancer Med. 2020 Aug;9(16):5699-5707. doi: 10.1002/cam4.3276. Epub 2020 Jul 6.
Liquid biopsy is a promising method in detecting colorectal cancer (CRC). However, previous meta-analyses only focused on the diagnostic performance of cell-free DNA (cfDNA). Therefore, we firstly evaluated the overall performance of all liquid biopsy methods. The pooled sensitivities, specificities, diagnostic odds ratios, and area under curve (AUC) of summary receiver operating characteristic curve for all liquid biopsy methods, exosomes, circulating tumor cells (CTCs), and cfDNA were calculated, respectively. A total of 62 articles involving 18 739 individuals were included. Fifty-one articles were about cfDNA, five articles were about CTCs, and six articles were about exosomes. The overall performance of all liquid biopsy methods had a pooled sensitivity, specificity, and AUC of 0.77 (95% confidence interval [CI] 0.76-0.78), 0.89 (95% CI 0.88-0.90), and 0.9004, respectively. The sensitivities were 0.82 (95% CI 0.79-0.85), 0.76 (95% CI 0.72-0.80), and 0.76 (95% CI 0.75-0.77) for CTCs, exosomes, and cfDNA, respectively. The specificities were 0.97 (95% CI95% CI 0.95-0.99), 0.92 (95% CI 0.89-0.94), and 0.88 (95% CI 0.87-0.89) for CTCs, exosomes, and cfDNA, respectively. The AUC were 0.9772, 0.9037, and 0.8963 for CTCs, exosomes, and cfDNA, respectively. The overall performance of all liquid biopsy methods had great diagnostic value in detecting CRC, regardless of subtypes. Among all liquid biopsy methods, CTCs showed the best diagnostic performance.
液体活检是检测结直肠癌（CRC）的一种很有前途的方法。然而，以前的荟萃分析仅集中于游离 DNA（cfDNA）的诊断性能。因此，我们首先评估了所有液体活检方法的整体性能。分别计算了所有液体活检方法、外泌体、循环肿瘤细胞（CTC）和 cfDNA 的汇总受试者工作特征曲线的敏感性、特异性、诊断优势比和曲线下面积（AUC）。共纳入 62 篇涉及 18739 人的文章。51 篇关于 cfDNA，5 篇关于 CTC，6 篇关于外泌体。所有液体活检方法的整体性能的汇总敏感性、特异性和 AUC 分别为 0.77（95%置信区间[CI]0.76-0.78）、0.89（95%CI0.88-0.90）和 0.9004。CTC、外泌体和 cfDNA 的敏感性分别为 0.82（95%CI0.79-0.85）、0.76（95%CI0.72-0.80）和 0.76（95%CI0.75-0.77）。特异性分别为 0.97（95%CI95%CI0.95-0.99）、0.92（95%CI0.89-0.94）和 0.88（95%CI0.87-0.89）。CTC、外泌体和 cfDNA 的 AUC 分别为 0.9772、0.9037 和 0.8963。所有液体活检方法在检测 CRC 方面均具有良好的诊断价值，无论亚型如何。在所有液体活检方法中，CTC 表现出最佳的诊断性能。
