Cell-free DNA in blood and urine as a diagnostic tool for bladder cancer: a meta-analysis

To assess the diagnostic performance of cell-free DNA assays in the detection of bladder cancer.

The quality of the studies included in this meta-analysis was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Statistical analyses were performed using the software RevMan 5.3 and Stata 14.0. We assessed the pooled sensitivity and specificity, positive/negative likelihood ratios (PLRs/NLRs), diagnostic odds ratios (DORs), and corresponding 95% confidence intervals (95% CIs). Summary receiver operating characteristic curve (ROC curve) and area under the curve (AUC) were used to summarize the overall test performance. Heterogeneity and publication bias were also examined.

Eleven studies included 802 bladder cancer patients and 668 controls met the eligibility criteria. The overall diagnostic accuracy was measured as follows: sensitivity 0.71 (95% CI = 0.64-0.77), specificity 0.78 (95% CI = 0.70-0.85), PLR 3.3 (95% CI = 2.4-54.5), NLR 0.37 (95% CI = 0.30-0.46), DOR 9 (95% CI = 6-14), and AUC 0.80 (95% CI = 0.77-0.83). Subgroup analysis suggested that ethnicity significantly accounted for the heterogeneity of specificity. The Deeks' funnel plot asymmetry test (P = 0.97) suggested no potential publication bias.

Cell-free DNA has a high diagnostic value in bladder cancer.

American journal of translational research. 2018 Jul 15*** epublish ***

Xin-Shuai Wang, Meng-Qi Zhao, Li Zhang, De-Jiu Kong, Xue-Zhen Ding, Xiao-Chen Hu, Jun-Qiang Yang, She-Gan Gao

Henan Key Laboratory of Cancer Epigenetics; Cancer Hospital, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology Luoyang 471003, China.