结直肠癌循环肿瘤DNA甲基化：荟萃分析。

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinica Chimica Acta Pub Date : 2025-08-08 DOI:10.1016/j.cca.2025.120543

Zhipeng Pan , Guoqing Li , Hanqing Wu , Faming Pan

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引用次数: 0

摘要

目的：综合评价循环肿瘤DNA （ctDNA）甲基化对结直肠癌（CRC）的诊断价值。方法：检索2025年3月4日前发表的相关文章。计算合并敏感性、特异性、阳性和阴性似然比、诊断优势比（DOR）和总受试者工作特征曲线下面积（AUC）。亚组分析和meta回归用于评估异质性的潜在来源。结果：本荟萃分析共纳入147篇文献，15133例结直肠癌患者。ctDNA甲基化的敏感性、特异性和DOR分别为0.655、0.902和20.662，AUC为0.8851。同时，ctDNA甲基化与癌胚抗原（CEA）结合的AUC为0.9269，敏感性为0.804，特异性为0.904。亚组分析和meta回归分析显示，多基因（AUC = 0.9059）和数字PCR （AUC = 0.8907）的诊断价值高于单基因和其他检测。基因剂量和检测方法可能是异质性的来源。这些文章不存在发表偏倚。结论：ctDNA甲基化的总体表现对CRC的早期筛查和诊断具有较高的诊断准确性，尤其是联合CEA后，但在临床应用前仍有许多有待解决的问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Circulating tumor DNA methylation in colorectal cancer: a meta-analysis

Objectives

To synthetically evaluate the diagnostic performance of circulating tumor DNA (ctDNA) methylation for colorectal cancer (CRC).

Methods

Relevant articles published before March 4, 2025 were searched. The pooled sensitivity, specificity, positive and negative likelihood ratio, diagnostic odds ratio (DOR), and the areas under the summary receiver operating characteristic curve (AUC) were calculated. Subgroup analysis and meta-regression were used to evaluate potential sources of heterogeneity.

Results

Totally, 147 articles containing 15,133 CRC patients were included in this meta-analysis. The pooled sensitivity, specificity and DOR of ctDNA methylation were 0.655, 0.902 and 20.662, respectively, yielding an AUC of 0.8851. Meanwhile, the combination of ctDNA methylation and carcinoembryonic antigen (CEA) achieved an AUC of 0.9269, with a sensitivity of 0.804, with a specificity of 0.904. Subgroup and meta-regression analyses indicated that the diagnostic value of multiple genes (AUC = 0.9059) and digital PCR assay (AUC = 0.8907) was higher than that of single gene and other assays. Gene dosage and detection method might be the sources of heterogeneity. There was no publication bias among these articles.

Conclusion

The overall performance of ctDNA methylation had great diagnostic accuracy for the early screening and diagnosis of CRC, especially after combining with CEA, but many open questions remain before clinical application.

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来源期刊

Clinica Chimica Acta 医学-医学实验技术

CiteScore

10.10

自引率

2.00%

发文量

1268

审稿时长

23 days

期刊介绍： The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells. The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.