Meta-Analysis of the Diagnostic Value of Cell-free DNA for Renal Cancer

Abstract

Cell-free DNA (cf-DNA) has been reported to represent a suitable material for liquid biopsy in the diagnosis and prognosis of various cancers. We performed a meta-analysis of published data to investigate the diagnostic value of cf-DNA for renal cancer (RCa). Systematic searches were conducted using Pubmed, Embase databases, Web of Science, Medline and Cochrane Library to identify relevant publications until the 31st March 2021. For all patients, we evaluated the true diagnostic value of cf-DNA by calculating the number of true positive, false positive, true negative, and false negative, diagnoses by extracting specificity and sensitivity data from the selected literature. In total, 8 studies, featuring 754 RCa patients, and 355 healthy controls, met our inclusion criteria. The overall diagnostic sensitivity and specificity for cf-DNA was 0.71 (95% confidence interval (CI), 0.55–0.83) and 0.79 (95% CI, 0.66–0.88), respectively. The pooled positive likelihood ratio and pooled negative likelihood ratio were 3.42 (95% CI, 2.04–5.72) and 0.36 (95% CI, 0.23–0.58), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79–0.85), and the diagnostic odds ratio was 7.80 (95% CI, 4.40–13.85). Collectively, our data demonstrate that cf-DNA has high specificity and sensitivity for diagnosing RCa. Therefore, cf-DNA is a useful biomarker for the diagnosis of RCa.

Cell‐free DNA 5‐hydroxymethylcytosine as a marker for common cancer detection

“…We found that both pan‐cancer and cancer–specific signatures had a high sensitivity (68.6% and 80.0%–96.4%, respectively) and high specificity (96.6% and 96.2%–100.0%, respectively). Previous studies using cfDNA concentration, fragment size, mutation and DNA methylation analyses have reported sensitivities and specificities for cancer detection of ∼34.8%–93.5% and 85.6%–96% in bladder cancer (from urine and plasma cfDNA), 18%–95.6% and 55%–100% in breast cancer, 4%–91% and 50%–100% in colorectal cancer, 18.2%–71% and 79%–99.5% in kidney cancer, 9%–93% and 57%–100% in lung cancer and 12%–93% and 70%–100% in prostate cancer 15,46–52 . Previous studies using plasma cfDNA 5hmC signatures have demonstrated a sensitivity and specificity of 87.5% and 83.9%, respectively, in lung cancer 53 .…”

“…Previous studies using cfDNA concentration, fragment size, mutation and DNA methylation analyses have reported sensitivities and specificities for cancer detection of ∼34.8%-93.5% and 85.6%-96% in bladder cancer (from urine and plasma cfDNA), 18%-95.6% and 55%-100% in breast cancer, 4%-91% and 50%-100% in colorectal cancer, 18.2%-71% and 79%-99.5% in kidney cancer, 9%-93% and 57%-100% in lung cancer and 12%-93% and 70%-100% in prostate cancer. 15,[46][47][48][49][50][51][52] Previous studies using plasma cfDNA 5hmC signatures have demonstrated a sensitivity and specificity of 87.5% and 83.9%, respectively, in lung cancer. 53 Our lung cancer-specific signature demonstrated a sensitivity of 94.1% or 98.0% and a specificity of 96.2% or 82.3% for patients from in-house and other-institute datasets, respectively.…”