Rodríguez-Ces Ana María, Rapado-González Óscar, Salgado-Barreira Ángel, Santos María Arminda, Aroso Carlos, Vinhas Ana Sofia, López-López Rafael, Suárez-Cunqueiro María Mercedes
Department of Surgery and Medical-Surgical Specialties, Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
Galician Precision Oncology Research Group (ONCOGAL), Medicine and Dentistry School, Universidade de Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
Diagnostics (Basel). 2024 Jul 9;14(14):1465. doi: 10.3390/diagnostics14141465.
Liquid biopsies have been identified as a viable source of cancer biomarkers. We aim to evaluate the diagnostic accuracy of cell-free DNA integrity (cfDI) in liquid biopsies for cancer. A comprehensive literature search was conducted through PubMed, Embase, Web of Science, and Cochrane Library up to June 2024. Seventy-two study units from forty-six studies, comprising 4286 cancer patients, were identified and evaluated. The Quality Assessment for Studies of Diagnostic Accuracy-2 (QUADAS-2) was used to assess study quality. Meta-regression analysis was employed to investigate the underlying factors contributing to heterogeneity, alongside an evaluation of publication bias. The bivariate random-effect model was utilized to compute the primary diagnostic outcomes and their corresponding 95% confidence intervals (CIs). The pooled sensitivity, specificity, and positive and negative likelihood ratios of cfDI in cancer diagnosis were 0.70 and 0.77, 3.26 and 0.34, respectively. The overall area under the curve was 0.84, with a diagnostic odds ratio of 10.63. This meta-analysis suggested that the cfDI index has a promising potential as a non-invasive and accurate diagnostic tool for cancer. Study registration: The study was registered at PROSPERO (reference No. CRD42021276290).
液体活检已被确定为癌症生物标志物的一个可行来源。我们旨在评估液体活检中游离DNA完整性（cfDI）对癌症的诊断准确性。截至2024年6月，通过PubMed、Embase、Web of Science和Cochrane图书馆进行了全面的文献检索。确定并评估了来自46项研究的72个研究单元，包括4286名癌症患者。使用诊断准确性研究质量评估-2（QUADAS-2）来评估研究质量。采用Meta回归分析来研究导致异质性的潜在因素，并评估发表偏倚。采用双变量随机效应模型计算主要诊断结果及其相应的95%置信区间（CIs）。cfDI在癌症诊断中的合并敏感性、特异性、阳性和阴性似然比分别为0.70和0.77、3.26和0.34。曲线下总面积为0.84，诊断比值比为10.63。这项Meta分析表明，cfDI指数作为一种非侵入性且准确的癌症诊断工具具有广阔的潜力。研究注册：该研究已在PROSPERO注册（注册号CRD42021276290）。
