Department of Radiology, The First Hospital of Lanzhou University, Lanzhou City, Gansu Province, China.
Department of Intelligent Science and Technology, Intelligent Imaging Medical Engineering Research Center of Gansu Province, Guangzhou City, Guangdong Province, China.
Expert Rev Mol Diagn. 2023 Jan;23(1):63-69. doi: 10.1080/14737159.2023.2167555. Epub 2023 Jan 18.
Circulating cell-free DNA (cfDNA) is a good diagnostic tool for hepatocellular carcinoma as it can comprehensively reflect the heterogeneity of tumors and aid in their early detection. This study aimed to assess the diagnostic value of circulating cfDNA for hepatocellular carcinoma.
PubMed, EMBASE, Web of Science, Cochrane Library, and Scopus databases were searched to identify all relevant literature from their dates of establishment to 6 April 2022, and a total of 2,467 articles were found. Methodological quality assessment was performed using QUADAS-2.
Fifteen articles with 3,686 patients were included in this study after screening. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve were 0.83 (95% confidence interval [CI]: 0.78, 0.87), 0.90 (95% CI: 0.86, 0.93), 8.4 (95% CI: 5.9, 12.0), 0.19 (95% CI: 0.15, 0.24), 44 (95% CI: 30, 66), and 0.93 (95% CI: 0.90, 0.95), respectively. Deek's funnel plot test did not show significant publication bias (P = 0.28).
Results of this meta-analysis suggest that circulating cfDNA has moderate sensitivity and excellent specificity for the detection of hepatocellular carcinoma as a noninvasive test (0.83 and 0.90, respectively).
循环游离 DNA（cfDNA）是一种用于诊断肝细胞癌的良好工具，因为它可以全面反映肿瘤的异质性，并有助于早期发现。本研究旨在评估循环 cfDNA 对肝细胞癌的诊断价值。
检索 PubMed、EMBASE、Web of Science、Cochrane Library 和 Scopus 数据库，从建库日期至 2022 年 4 月 6 日，共检索到 2467 篇相关文献。使用 QUADAS-2 进行方法学质量评估。
经过筛选，本研究共纳入 15 篇文献，共计 3686 例患者。汇总后的敏感性、特异性、阳性似然比、阴性似然比、诊断优势比和曲线下面积分别为 0.83（95%置信区间[CI]：0.78，0.87）、0.90（95% CI：0.86，0.93）、8.4（95% CI：5.9，12.0）、0.19（95% CI：0.15，0.24）、44（95% CI：30，66）和 0.93（95% CI：0.90，0.95）。Deek 漏斗图检验未显示出显著的发表偏倚（P=0.28）。
本荟萃分析结果表明，循环 cfDNA 作为一种非侵入性检测方法，对肝细胞癌的检测具有中等敏感性和极好的特异性（分别为 0.83 和 0.90）。
