Diagnostic performance of various liquid biopsy methods in detecting colorectal cancer: A meta‐analysis

Abstract

Liquid biopsy is a promising method in detecting colorectal cancer (CRC). However, previous meta‐analyses only focused on the diagnostic performance of cell‐free DNA (cfDNA). Therefore, we firstly evaluated the overall performance of all liquid biopsy methods. The pooled sensitivities, specificities, diagnostic odds ratios, and area under curve (AUC) of summary receiver operating characteristic curve for all liquid biopsy methods, exosomes, circulating tumor cells (CTCs), and cfDNA were calculated, respectively. A total of 62 articles involving 18 739 individuals were included. Fifty‐one articles were about cfDNA, five articles were about CTCs, and six articles were about exosomes. The overall performance of all liquid biopsy methods had a pooled sensitivity, specificity, and AUC of 0.77 (95% confidence interval [CI] 0.76‐0.78), 0.89 (95% CI 0.88‐0.90), and 0.9004, respectively. The sensitivities were 0.82 (95% CI 0.79‐0.85), 0.76 (95% CI 0.72‐0.80), and 0.76 (95% CI 0.75‐0.77) for CTCs, exosomes, and cfDNA, respectively. The specificities were 0.97 (95% CI95% CI 0.95‐0.99), 0.92 (95% CI 0.89‐0.94), and 0.88 (95% CI 0.87‐0.89) for CTCs, exosomes, and cfDNA, respectively. The AUC were 0.9772, 0.9037, and 0.8963 for CTCs, exosomes, and cfDNA, respectively. The overall performance of all liquid biopsy methods had great diagnostic value in detecting CRC, regardless of subtypes. Among all liquid biopsy methods, CTCs showed the best diagnostic performance.

Liquid biopsy in endometrial cancer

“…The methodologies depend on the purpose of ctDNA [44][45][46][47][48] : (1) Quantitative PCR (qPCR): This procedure is used for the evaluation of total cfDNA amount and/or cfDNA integrity. To be sure to identify properly ctDNA coming from EC (and not from others tumors or pathologies), it is necessary to refer to specific mutations present in the tumor.…”

Pancreatic Cancer: Pathogenesis, Screening, Diagnosis, and Treatment

“…Biomarkers may help detect microscopic high-grade PanIN precursors or early stage PDAC (Figure 1), clarify ambiguous screen-detected lesions, or prevent interval cancers in patients with a normal pancreas or trivial abnormalities on imaging. We look forward to continued progress with research on the discovery, optimization, and clinical validation of biomarkers in pancreatic juice (such as mutant TP53/SMAD4 DNA 119 ) and blood (such as CA19-9, HbA1C plus other tumor markers, [120][121][122] circulating tumor cells, 123 exosomes, 123 circulating-tumor DNA [ctDNA], 124 or cell-free DNA [cfDNA] 124 ). For the latter, the biggest challenge is the very low levels of peripheral DNA, which affects sensitivity, 123 particularly for early-stage disease.…”

“…We look forward to continued progress with research on the discovery, optimization, and clinical validation of biomarkers in pancreatic juice (such as mutant TP53/SMAD4 DNA 119 ) and blood (such as CA19-9, HbA1C plus other tumor markers, [120][121][122] circulating tumor cells, 123 exosomes, 123 circulating-tumor DNA [ctDNA], 124 or cell-free DNA [cfDNA] 124 ). For the latter, the biggest challenge is the very low levels of peripheral DNA, which affects sensitivity, 123 particularly for early-stage disease. A PDACspecific antibody-based microarray test (IMMray PanCand, Immunovia, Marlborough, MA) measuring 8 serum biomarkers plus CA19-9, is being tested to determine the presence of a high-risk signature for PDAC.…”

The role of exosomes in liquid biopsy for cancer diagnosis and prognosis prediction

“…In another meta‐analysis, CTCs showed the best performance in colorectal cancer (CRC) diagnosis compared to cfDNA and exosomes. But the number of studies about CTCs (5) and exosomes (6) is significantly less than that of cfDNA (51), which might introduce bias and lead to inaccurate outcomes 66 . For getting more accurate predictive outcomes, Vafaei et al recommended the combination of CTCs and blood exosomes in CRC diagnosis and prognosis 67 …”

“…66 For getting more accurate predictive outcomes, Vafaei et al recommended the combination of CTCs and blood exosomes in CRC diagnosis and prognosis. 67…”