Meng Hui, Yao Wu, Nan Man-Man, Zhou Fu-Guang, Song Wen-Yan, Li Yi-Zhen, Yin Yu-Hui, Ding Yi
Department of Pathology, First Affiliated Hospital of Zhengzhou University Zhengzhou, Henan, China.
College of Public Health, Zhengzhou University Zhengzhou, Henan, China.
Am J Cancer Res. 2023 Apr 15;13(4):1594-1601. eCollection 2023.
Lung cancer is the leading cause of cancer-related deaths globally. Early detection of lung cancer can lead to more effective treatment and improved survival. Circulatory abnormal cells (CACs) with specific chromosomal variation may be used to diagnose lung cancer and to differentiate benign from malignant nodules. The value of CAC in precancer diagnosis, however, remains controversial. In this study, a systematic review and meta-analysis are conducted to clarify the diagnostic value of CAC in early-stage lung cancer. A systematic literature search was conducted using the following medical topic title terms and text-free words: "circulating genetically abnormal cells", "CACs", "liquid biopsy", "early lung cancer", "non-small cell lung cancer", "diagnostic accuracy", "sensitivity" and "specificity" in Science Direct, CNKI and Wanfang databases, respectively. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the curve were analyzed by STATA15.0 (MP) software. Deek funnel plots were used to assess potential publication bias. Heterogeneity was tested using the I2 statistic and the Cochrane Q test. 7 major studies were included in this meta-analysis, and a total of 53728 participants were analyzed. In the diagnosis of early lung cancer, CAC had pooled sensitivity, specificity, and receiver operating characteristics of 0.80 (95% CI: 0.73-0.86), 0.85 (95% CI: 0.69-0.94), and 0.87 (95% CI: 0.84-0.90). The combined positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and diagnostic score were 23.36 (95% CI: 7.33-74.46), 5.42 (95% CI: 2.37-12.43), 0.23 (95% CI: 0.16-0.35) and 3.15 (95% CI: 1.99-4.31) respectively. Publication bias was not detected. The CAC is effective at detecting lung cancer in its early stages.
肺癌是全球癌症相关死亡的主要原因。早期发现肺癌可带来更有效的治疗并提高生存率。具有特定染色体变异的循环异常细胞（CACs）可用于诊断肺癌，并区分良性和恶性结节。然而，CAC在癌前诊断中的价值仍存在争议。在本研究中，进行了一项系统评价和荟萃分析，以阐明CAC在早期肺癌中的诊断价值。分别在科学Direct、中国知网和万方数据库中使用以下医学主题标题词和无文本词进行系统文献检索：“循环基因异常细胞”、“CACs”、“液体活检”、“早期肺癌”、“非小细胞肺癌”、“诊断准确性”、“敏感性”和“特异性”。使用STATA15.0（MP）软件分析敏感性、特异性、阳性似然比、阴性似然比和曲线下面积。使用Deek漏斗图评估潜在的发表偏倚。使用I2统计量和Cochrane Q检验检验异质性。本荟萃分析纳入了7项主要研究，共分析了53728名参与者。在早期肺癌的诊断中，CAC的合并敏感性、特异性和受试者操作特征分别为0.80（95%CI：0.73-0.86）、0.85（95%CI：0.69-0.94）和0.87（95%CI：0.84-0.90）。合并的阳性似然比、阴性似然比、诊断比值比和诊断分数分别为23.36（95%CI：7.33-74.46）、5.42（95%CI：2.37-12.43）、0.23（95%CI：0.16-0.35）和3.15（95%CI：1.99-4.31）。未检测到发表偏倚。CAC在早期检测肺癌方面是有效的。
