Tan Xiangyu, Yan Han, Chen Lei, Zhang Yuyang, Sun Chunyan
Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, China.
Front Oncol. 2021 Mar 4;11:632910. doi: 10.3389/fonc.2021.632910. eCollection 2021.
Circulating tumor DNA (ctDNA) has offered a minimally invasive approach for the detection and measurement of cancer. However, its diagnostic and prognostic value in hematological malignancies remains unclear. Pubmed, Embase, and Cochrane Library were searched for relating literature. Diagnostic accuracy variables and disease progression prediction data were pooled by the Meta-Disc version 1.4 software. Review Manager version 5.4 software was applied for prognostic data analysis. A total of 11 studies met our inclusion criteria. In terms of diagnosis, the pooled sensitivity and specificity were 0.51 (95% confidence intervals (CI) 0.38-0.64) and 0.96 (95% CI 0.88-1.00), respectively. The AUSROC (area under the SROC) curve was 0.89 (95%CI 0.75-1.03). When it comes to the prediction of disease progression, the overall sensitivity and specificity was 0.83 (95% CI 0.67-0.94) and 0.98 (95% CI 0.93-1.00), respectively. Moreover, a significant association also existed between the presence of ctDNA and worse progression-free survival (HR 2.63, 95% CI 1.27-5.43, = 0.009), as well as overall survival (HR 2.92, 95% CI 1.53-5.57, = 0.001). The use of ctDNA in clinical practice for hematological malignancies is promising, as it may not only contribute to diagnosis, but could also predict the prognosis of patients so as to guide treatment. In the future, more studies are needed to realize the standardization of sequencing techniques and improve the detection sensitivity of exploration methods.
循环肿瘤DNA（ctDNA）为癌症的检测和测量提供了一种微创方法。然而，其在血液系统恶性肿瘤中的诊断和预后价值仍不明确。检索了PubMed、Embase和Cochrane图书馆中的相关文献。通过Meta-Disc 1.4版软件汇总诊断准确性变量和疾病进展预测数据。应用Review Manager 5.4版软件进行预后数据分析。共有11项研究符合纳入标准。在诊断方面，汇总的敏感性和特异性分别为0.51（95%置信区间（CI）0.38 - 0.64）和0.96（95%CI 0.88 - 1.00）。AUSROC（SROC曲线下面积）曲线为0.89（95%CI 0.75 - 1.03）。在疾病进展预测方面，总体敏感性和特异性分别为0.83（95%CI 0.67 - 0.94）和0.98（95%CI 0.93 - 1.00）。此外，ctDNA的存在与无进展生存期较差（HR 2.63，95%CI 1.27 - 5.43，P = 0.009）以及总生存期较差（HR 2.92，95%CI 1.53 - 5.57，P = 0.001）之间也存在显著关联。ctDNA在血液系统恶性肿瘤临床实践中的应用前景广阔，因为它不仅可能有助于诊断，还可以预测患者的预后以指导治疗。未来，需要更多研究来实现测序技术的标准化并提高检测方法的敏感性。
