Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Expert Rev Mol Diagn. 2021 Apr;21(4):417-427. doi: 10.1080/14737159.2021.1910025. Epub 2021 Apr 19.
There is tremendous interest in the development of liquid biopsy techniques, but the potential role of liquid biopsy for the early detection of cancer has not yet been elucidated. We aim to explore the performance of liquid biopsy in the early diagnosis of cancer.
A systematic review was conducted of liquid biopsy in cancer early detection. Meta-regression was carried out to explore the source of heterogeneity and publication bias was also evaluated.
Overall, there were six types of biomarkers and 17 studies focusing on liquid biopsy in the early detection of cancer, 7 studies in ctDNA, 5 studies in cfDNA, 2 studies in CTC, and the other three studies used circulating nucleosome, microRNA, and multiple biomarkers, respectively. Pooled sensitivity and specificity of liquid biopsy in cancer early detection was 0.76 (95%CI:0.67-0.83) and 0.92 (95%CI:0.86-0.96) and the area under the SROC curve was 0.91 (95%CI:0.88-0.93).
The current evidence shows that liquid biopsy has relatively low sensitivity and high specificity in cancer early detection. Among all these biomarkers, cfDNA may have potentially promising value in cancer early detection, thereby supporting further study of cancer early detection.
The study is registered at PROSPERO (Identifier number: CRD42020137205).
液体活检技术的发展引起了极大的兴趣，但液体活检在癌症早期检测中的潜在作用尚未阐明。我们旨在探讨液体活检在癌症早期诊断中的性能。
对癌症早期检测中的液体活检进行了系统评价。进行了荟萃回归分析以探索异质性的来源，并评估了发表偏倚。
总体而言，有六种类型的生物标志物和 17 项关于癌症早期检测的液体活检研究，7 项关于 ctDNA，5 项关于 cfDNA，2 项关于 CTC，另外三项研究分别使用循环核小体、microRNA 和多种生物标志物。液体活检在癌症早期检测中的合并敏感性和特异性分别为 0.76（95%CI：0.67-0.83）和 0.92（95%CI：0.86-0.96），SROC 曲线下面积为 0.91（95%CI：0.88-0.93）。
目前的证据表明，液体活检在癌症早期检测中的敏感性相对较低，特异性较高。在所有这些生物标志物中，cfDNA 在癌症早期检测中可能具有潜在的有前途的价值，从而支持进一步研究癌症早期检测。
该研究在 PROSPERO（标识符号：CRD42020137205）中注册。
