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循环肿瘤DNA在胶质瘤分子特征中的诊断价值：一项荟萃分析。

Diagnostic value of circulating tumor DNA in molecular characterization of glioma: A meta-analysis.

作者信息

Kang Yin, Lin Xiaohua, Kang Dezhi

机构信息

Department of Neurosurgery.

Department of Anesthesiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.

出版信息

Medicine (Baltimore). 2020 Aug 14;99(33):e21196. doi: 10.1097/MD.0000000000021196.

DOI:10.1097/MD.0000000000021196
PMID:32871983
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7437834/
Abstract

INTRODUCTION

Circulating tumor DNA (ctDNA) has provided a minimally invasive approach for the detection of genetic mutations in glioma. However, the diagnostic value of ctDNA in glioma remains unclear. This meta-analysis was designed to investigate the diagnostic value of ctDNA, compared with the current "criterion standard" tumor tissues.

MATERIALS AND METHODS

The included studies were collected by searching PubMed, Web of Science, Cochrane Library, and Embase databases. All statistical analyses were performed using the STATA12.0 and Meta-DiSc1.4 software.

RESULT

A total of 11 studies comprising 522 glioma patients met our inclusion criteria. The pooled sensitivity and specificity were 0.69 (95% confidence interval [CI] 0.66-0.73) and 0.98 (95% CI 0.96-0.99), respectively. The pooled diagnostic odds ratio was 23.27 (95% CI 13.69-39.53) and the area under the curve of the summary receiver operating characteristics curve was 0.90 (95% CI 0.89-0.92).

CONCLUSIONS

ctDNA analysis is an effective method to detect the genetic mutation status in glioma patients with high specificity and relatively moderate sensitivity. The application of high-throughput technologies, the detection of patients with high-grade glioma, and sampling from cerebrospinal fluid could have higher diagnostic accuracy. The improvement of detection methods and more large-sample case-control studies are required in the future.

摘要

引言

循环肿瘤DNA（ctDNA）为检测胶质瘤中的基因突变提供了一种微创方法。然而，ctDNA在胶质瘤中的诊断价值仍不明确。本荟萃分析旨在研究ctDNA与当前“标准标准”肿瘤组织相比的诊断价值。

材料与方法

通过检索PubMed、科学网、考克兰图书馆和Embase数据库收集纳入研究。所有统计分析均使用STATA12.0和Meta-DiSc1.4软件进行。

结果

共有11项研究（包括522例胶质瘤患者）符合我们的纳入标准。合并敏感度和特异度分别为0.69（95%置信区间[CI]0.66 - 0.73）和0.98（95%CI 0.96 - 0.99）。合并诊断比值比为23.27（95%CI 13.69 - 39.53），汇总受试者工作特征曲线下面积为0.90（95%CI 0.89 - 0.92）。

结论

ctDNA分析是检测胶质瘤患者基因突变状态的有效方法，具有高特异性和相对中等的敏感度。高通量技术的应用、高级别胶质瘤患者的检测以及脑脊液采样可能具有更高的诊断准确性。未来需要改进检测方法并开展更多大样本病例对照研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4a/7437834/a7a94b340932/medi-99-e21196-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4a/7437834/ee02c3c08471/medi-99-e21196-g001.jpg
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