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Meta-Analysis
. 2014 Sep 9:4:6269.
doi: 10.1038/srep06269.

Diagnostic value of circulating free DNA for the detection of EGFR mutation status in NSCLC: a systematic review and meta-analysis

Jie Luo  1 , Li Shen  1 , Di Zheng  2
Affiliations
Meta-Analysis

Diagnostic value of circulating free DNA for the detection of EGFR mutation status in NSCLC: a systematic review and meta-analysis

Jie Luo et al. Sci Rep. .

Abstract

Epidermal growth factor receptor (EGFR) mutation is a reliable and sensitive biomarker for EGFR-TKI therapy in non-small-cell lung cancer (NSCLC). However, detection of EGFR mutation in tissues has obvious limitations. Circulating free DNA (cfDNA) has been reported as an alternative approach for the detection of EGFR mutations. This systematic review and meta-analysis was designed to assess the diagnostic performance of cfDNA, compared with tissues. True-positive (TP), false-positive (FP), false-negative (FN), and true-negative (TN) values were extracted or calculated for each study. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated. A summary receiver operating characteristic curve (SROC) and area under curve (AUC) were used to evaluate the overall diagnostic performance. 20 eligible studies involving 2012 cases were included in this meta-analysis. The pooled sensitivity, specificity, PLR, NLR, and DOR were 0.674 (95%CI: 0.517-0.800), 0.935 (95%CI: 0.888-0.963), 10.307 (95%CI: 6.167-17.227), 0.348 (95%CI: 0.226-0.537), and 29.582 (95%CI: 4.582-60.012), respectively. The AUC was 0.93 (95% CI: 0.90-0.95). The meta-analysis suggests that detection of EGFR mutation by cfDNA is of adequate diagnostic accuracy and cfDNA analysis could be a promising screening test for NSCLC.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Flow diagram of study selection.
Figure 2
Figure 2. Forest plots of sensitivity and specificity of cfDNA.
The pooled sensitivity was 0.691 (95% CI: 0.569–0.790) and the pooled specificity was 0.922 (95% CI: 0.878–0.951).
Figure 3
Figure 3. The summary operative receiver characteristic curve indicated high diagnostic accuracy (A, the area under summary receiver characteristics curve was) and Fagan plot presents the clinical utility of cfDNA (B).
Figure 4
Figure 4. Deek's funnel plot showed no significant publication bias (A) and sensitivity analysis showed that the pooled results were robust and not affected by individual studies (B).
The P value of Deek's funnel plot was 0.243, indicating no significant publication bias.
See this image and copyright information in PMC

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