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June 2, 2016
Background
Quantitative
analyses of circulating cell-free DNA (cfDNA) are potential methods for
the detection of ovarian cancer. Many studies have evaluated these
approaches, but the results were too inconsistent to be conclusive. This
study is the first to systematically evaluate the accuracy of
circulating cfDNA for the diagnosis of ovarian cancer by conducting
meta-analysis.
Methods
We
searched PubMed, Embase, Cochrane Library and the Chinese National
Knowledge Infrastructure (CNKI) databases systematically for relevant
literatures
up to December 10, 2015. All analyses were conducted using
Meta-DiSc1.4 and Stata 12.0 software. Sensitivity, specificity and other
measures of accuracy of circulating cfDNA for the diagnosis of ovarian
cancer were pooled. Meta-regression was performed to identify the
sources of heterogeneity.
Results
This
meta-analysis included a total of 9 studies, including 462 ovarian
cancer patients and 407 controls. The summary estimates for quantitative
analysis of circulating cfDNA in ovarian cancer screen were as follows:
sensitivity, 0.70;
specificity, 0.90; positive likelihood ratio, 6.60; negative likelihood ratio, 0.34; diagnostic odds ratio, 26.05; and area
under the curve, 0.89, respectively. There was no
statistical significance for the evaluation of publication bias.
Conclusions
Current
evidence suggests that quantitative analysis of cfDNA has
unsatisfactory sensitivity but acceptable specificity for the diagnosis
of ovarian cancer. Further large-scale prospective studies are required
to validate the potential applicability of using
circulating cfDNA alone
or in combination with conventional markers as diagnostic biomarker for
ovarian cancer and explore potential factors that may influence the
accuracy of ovarian cancer diagnosis.
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