Liquid biopsy biomarkers in cervical cancer: A systematic review and meta-analysis

Background/objectives

Liquid biopsy biomarkers are emerging as vital tools for cancer screening and diagnosis, offering a noninvasive and accurate approach to early malignancy detection. This study aimed to assess the diagnostic performance of circulating biomarkers in cervical cancer (CC).

Methods

A comprehensive literature search was conducted across the Cochrane Library, PubMed, SCOPUS, and Web of Science, identifying 130 studies, of which 11 met the inclusion criteria. Data on true and false positives and negatives were extracted to calculate pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratios (DORs), and 95 % confidence intervals (CIs). Study quality and risk of bias were evaluated using the QUADAS-2 tool, while publication bias was assessed via Deeks’ funnel plot.

Results

The meta-analysis included 1301 patients, 670 healthy controls, and 438 individuals with benign or precancerous lesions. Pooled sensitivity was 0.68 (95 % CI: 0.65–0.70), and specificity was 0.84 (95 % CI: 0.81–0.86). The DOR was 61.10 (95 % CI: 32.20–115.9), with an area under the curve (AUC) of 0.95. Most studies demonstrated a low risk of bias, and no significant publication bias was observed (P = 0.06). Plasma-based liquid biopsies and miRNA biomarkers exhibited superior diagnostic performance.

Conclusions

These findings suggest that liquid biopsy biomarkers may substantially enhance the accuracy of cervical cancer detection, representing a promising strategy for early diagnosis.