循环肿瘤DNA在乙型肝炎病毒所致肝细胞癌中的诊断价值：一项系统评价和荟萃分析

The diagnostic value of circulating tumor DNA in hepatitis B virus induced hepatocellular carcinoma: a systematic review and meta-analysis.

作者信息

Chang Young, Jeong Soung Won, Jang Jae Young, Eun Hyuksoo, Lee Young-Sun, Song Do Seon, Yu Su Jong, Lee Sae Hwan, Kim Won, Lee Hyun Woong, Kim Sang Gyune, Ryu Seongho, Park Suyeon

机构信息

Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.

Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.

出版信息

J Liver Cancer. 2022 Sep;22(2):167-177. doi: 10.17998/jlc.2022.09.19. Epub 2022 Sep 29.

DOI:10.17998/jlc.2022.09.19

PMID:37383408

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10035733/

Abstract

BACKGROUND/AIM: New biomarkers are urgently needed to aid in the diagnosis of early stage hepatocellular carcinoma (HCC). We performed a meta-analysis on the diagnostic utility of circulating tumor DNA (ctDNA) levels in patients with hepatitis B virus-induced HCC.

METHODS

We retrieved relevant articles from PubMed, Embase, and the Cochrane Library up to February 8, 2022. Two subgroups were defined; one subset of studies analyzed the ctDNA methylation status, and the other subset combined tumor markers and ctDNA assays. Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC) were analyzed.

RESULTS

Nine articles including 2,161 participants were included. The overall SEN and SPE were 0.705 (95% confidence interval [CI], 0.629-0.771) and 0.833 (95% CI, 0.769-0.882), respectively. The DOR, PLR, and NLR were 11.759 (95% CI, 7.982-17.322), 4.285 (95% CI, 3.098-5.925), and 0.336 (0.301-0.366), respectively. The ctDNA assay subset exhibited an AUC of 0.835. The AUC of the combined tumor marker and ctDNA assay was 0.848, with an SEN of 0.761 (95% CI, 0.659-0.839) and an SPE of 0.828 (95% CI, 0.692-0.911).

CONCLUSIONS

Circulating tumor DNA has promising diagnostic potential for HCC. It can serve as an auxiliary tool for HCC screening and detection, especially when combined with tumor markers.

摘要

背景/目的：迫切需要新的生物标志物来辅助早期肝细胞癌（HCC）的诊断。我们对乙型肝炎病毒所致HCC患者循环肿瘤DNA（ctDNA）水平的诊断效用进行了一项荟萃分析。

方法

截至2022年2月8日，我们从PubMed、Embase和Cochrane图书馆检索了相关文章。定义了两个亚组；一组研究分析ctDNA甲基化状态，另一组研究结合肿瘤标志物和ctDNA检测。分析合并敏感度（SEN）、特异度（SPE）、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）和汇总接受者操作特征曲线下面积（AUC）。

结果

纳入9篇文章，共2161名参与者。总体SEN和SPE分别为0.705（95%置信区间[CI]，0.629 - 0.771）和0.833（95%CI，0.769 - 0.882）。DOR、PLR和NLR分别为11.759（95%CI，7.982 - 17.322）、4.285（95%CI，3.098 - 5.925）和0.336（0.301 - 0.366）。ctDNA检测亚组的AUC为0.835。联合肿瘤标志物和ctDNA检测的AUC为0.848，SEN为0.761（95%CI，0.659 - 0.839），SPE为0.828（95%CI，0.692 - 0.911）。