Evaluation of cell‐free DNA accuracy as diagnostic biomarker for prostate cancer: A systematic review and meta‐analysis

Abstract

This updated meta-analysis aimed to assess the diagnostic performance of circulating cell-free DNA (cf-DNA) for prostate cancer (PCa). Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Embase databases to retrieve related studies. Several diagnostic estimates, including sensitivity (SE), specificity (SP), likelihood ratios (LRs), and diagnostic odds ratio (DOR) were also used to perform the meta-synthesis. Additionally, the area under hierarchical summary receiver operating characteristic curves (AU-HSROC) was used as a global measure of test accuracy. Results: Twenty-nine unique articles were enrolled in the meta-analysis. Pooled SE and SP for overall accuracy of cf-DNA in PCa were obtained as 0.54 (95% CI: 0.47-0.61) and 0.92 (95% CI: 0.88-0.95), respectively. Positive LR (PLR) was 6.8 (95% CI: 4.9-9.5, I 2 : 92.98%) and negative LR (NLR) was 0.5 (95% CI: 0.43-0.58).Pooled DOR was 13.56 (95% CI: 9.49-19.37) and the AU-HSROC was 0.83 (95% CI: 0.79-0.86). Conclusion:The present study suggested that cf-DNA assays have comparable SE as well as remarkably higher SP (qualitative assays) than common biomarkers in the detection of PCa like prostate-specific antigen (PSA). In addition, cf-DNA assays have better performance in PCa confirmation and almost similar performance to PSA in excluding PCa patients.

Quantitation and Characterization of Cell-Free Mitochondrial DNA in Plasma by Deep Sequencing

“…Apart from the mtDNA sequence selected for ampli cation, the qPCR strategy is incapable of delineating the mitochondrial genomic origin of other mitochondrial fragments present in plasma but outside of the selected sequence. Finally, qPCR lacks information about sequence variants in mtDNA DAMPs, limiting opportunities to utilize the cell-free DNA as a diagnostic marker, as it done in some studies of cancer [23][24][25] .…”