摘要
目的 探讨循环肿瘤DNA(ctDNA)在晚期非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)突变检测中的应用价值。方法 检索PubMed、Embase、Medline、万方数据库、中国知网数据库、中国生物医学文献数据库、维普数据库,纳入报道了ctDNA检测晚期NSCLC患者EGFR突变灵敏度与特异度的文献;采用合并灵敏度、特异度、似然比点状图、集成受试者工作特征(SROC)曲线及曲线下面积(AUC)评估ctDNA诊断价值。结果 共纳入28篇文献,包括3 644例晚期NSCLC患者,合并后的灵敏度、特异度分别为64.0%(95% CI :0.59~0.70)、98.0%(95% CI :0.95~0.99)。SROC曲线下面积为0.85(95% CI :0.82~0.88),表明ctDNA有较高的诊断价值。结论 对于晚期NSCLC患者EGFR突变的检测,ctDNA是一个高特异性及高诊断价值的生物标志物,ctDNA基因检测将是晚期NSCLC患者个体化靶向治疗的重要组成部分。
Objective To investigate the diagnostic value of circulating tumor DNA (ctDNA) for the detection of epidermal growth factor receptor (EGFR) mutation in patients with advanced non-small lung cancer (NSCLC). Methods PubMed,Embase,Medline,CNKI,Wangfang Database,CBMdisc and VIP Database were retrieved to identify eligible studies which reported the sensitivity and specificity of ctDNA for detection of EGFR mutation status in advanced NSCLC.Overall diagnostic performance of the test was evaluated by pooled sensitivity,specificity,likelihood ratio scatter gram,SROC and AUC. Results Twenty eight eligible studies involving 3 644 participants were included.Pooled sensitivity,specificity was 64.0%(95% CI :0.59-0.70),98.0%(95% CI :0.95-0.99).The AUC diagnostic value was 0.85(95% CI :0.82-0.88),indicating the high diagnostic performance of ctDNA. Conclusion CtDNA is a highly specific and effective biomarker for the detection of EGFR mutation in advanced patients with NSCLC,and ctDNA will be a key part of personalized cancer therapy of advanced NSCLC.
作者
康雪丽
王怡
李升锦
KANG Xueli;WANG Yi;LI Shengjin(Department of Respiratory Medicine,The Second Affiliated Hospital of ChongqingMedical University,Chongqing 400010,China;Department of Respiratory Medicine,Sichuan Provincial Fouth People′s Hospital,Chengdu,Sichuan 610016,China)
出处
《检验医学与临床》
CAS
2019年第12期1681-1686,1691,共7页
Laboratory Medicine and Clinic
