Department of Respiratory, Zhejiang Hospital, Hangzhou, China.
Thorac Cancer. 2021 Nov;12(21):2907-2913. doi: 10.1111/1759-7714.14151. Epub 2021 Sep 20.
The aim of this study was to quantitatively analysis the diagnostic performance of adenomatous polyposis coli (APC) gene promoter methylation in serum or sputum/bronchoalveolar lavage fluid (BLAF) as a biomarker for lung cancer identification through pooling of open published data.
The relevant electronic MEDLINE, EMBASE, Ovid, web of science and CNKI databases were systematically searched to identify the studies related to APC gene promoter methylation for lung cancer diagnosis. Data of true positive (tp), false positive (fp), false negative (fn) and true negative (tn) were extracted from the publications included in the study. The pooled diagnostic sensitivity, specificity and area under summary receiver operating characteristic (SROC) curve (AUC-SROC) of APC gene promoter methylation were calculated. Publication bias was evaluated by Begg's funnel plot and Egger's line regression test.
Fourteen studies associated with APC gene promoter methylation and lung cancer were identified in the databases and finally included in the meta-analysis. The data was pooled using a random effect model due to significant statistical heterogeneity across the 14 studies (p < 0.05). Using the APC gene promoter methylation as a reference for lung cancer identification, the pooled diagnostic sensitivity and specificity were 0.43 (95% CI: 0.40-0.45), and 0.92 (95% CI: 0.90-0.95), respectively with combined diagnostic positive likelihood ratio (+LR) and negative likelihood ratio (-LR) of 7.15 (95% CI: 3.62-14.12) and 0.63 (95% CI: 0.57-0.71). The pooled diagnostic odds ratio (DOR) and AUC-SROC of APC gene promoter methylation for lung cancer diagnosis were 9.84 (95% CI: 5.77-16.79) and 0.7, respectively. The Begg's funnel plot and Egger's line regression test both indicated statistical publication bias (t = 5.40, p < 0.05).
APC gene promoter methylation in serum or sputum/BLAF is a potential biomarker for lung cancer diagnosis with high specificity. However, due to its low sensitivity, it may not be suitable for lung cancer screening in the general population.
本研究旨在通过汇总已发表的公开数据，定量分析腺瘤性结肠息肉病（APC）基因启动子甲基化在血清或痰液/支气管肺泡灌洗液（BALF）中作为肺癌识别的生物标志物的诊断性能。
系统检索相关电子 MEDLINE、EMBASE、Ovid、Web of Science 和中国知网（CNKI）数据库，以确定与 APC 基因启动子甲基化用于肺癌诊断相关的研究。从纳入研究的出版物中提取真阳性（tp）、假阳性（fp）、假阴性（fn）和真阴性（tn）的数据。计算 APC 基因启动子甲基化的汇总诊断敏感性、特异性和汇总受试者工作特征（SROC）曲线下面积（AUC-SROC）。通过 Begg 漏斗图和 Egger 线性回归检验评估发表偏倚。
在数据库中确定了 14 项与 APC 基因启动子甲基化和肺癌相关的研究，并最终纳入荟萃分析。由于 14 项研究之间存在显著的统计学异质性（p<0.05），因此使用随机效应模型对数据进行汇总。使用 APC 基因启动子甲基化为肺癌识别的参考，汇总的诊断敏感性和特异性分别为 0.43（95%CI：0.40-0.45）和 0.92（95%CI：0.90-0.95），合并诊断阳性似然比（+LR）和阴性似然比（-LR）分别为 7.15（95%CI：3.62-14.12）和 0.63（95%CI：0.57-0.71）。APC 基因启动子甲基化对肺癌诊断的汇总诊断优势比（DOR）和 AUC-SROC 分别为 9.84（95%CI：5.77-16.79）和 0.7。Begg 漏斗图和 Egger 线性回归检验均表明存在统计学发表偏倚（t=5.40，p<0.05）。
血清或痰液/BALF 中的 APC 基因启动子甲基化是一种具有高特异性的肺癌诊断潜在生物标志物。然而，由于其敏感性较低，它可能不适合用于一般人群的肺癌筛查。
