title: Value of quantitative analysis of circulating cell free DNA as a screening tool for lung cancer: a meta-analysis.
abstract: OBJECTIVE
  Quantitative analysis of circulating cell free DNA is considered as a possible aid for lung cancer screening. We aimed to comprehensively review the evidence for use of circulating cell free DNA to screen for lung cancer.
  
  
  METHODS
  After a systematic review of English language studies, sensitivity, specificity, and other measures of accuracy of circulating DNA assay in the diagnosis of lung cancer were pooled using random-effects models. Summary receiver operating characteristic curves were used to summarize overall test performance.
  
  
  RESULTS
  Ten studies met our inclusion criteria. The summary estimates for quantitative analysis of circulating cell free DNA in lung cancer screening in the studies included were as follows: sensitivity, 0.80 (95% confidence interval (CI), 0.77-0.83); specificity, 0.77 (95% CI, 0.74-0.80); positive likelihood ratio, 4.54 (95% CI, 2.66-7.76); negative likelihood ratio, 0.28 (95% CI, 0.19-0.40); and diagnostic odds ratio, 20.33 (95% CI, 10.12-40.86).
  
  
  CONCLUSIONS
  The current evidence suggests that the diagnostic accuracy of quantitative analysis of circulating DNA is not lower than conventional serum biomarkers for lung cancer screening, at least. However, it is not recommend for lung cancer screening alone, because its discrimination power is not very perfect. The value of circulating DNA assay in combination with conventional markers for lung cancer detection deserved further investigation.
authors.affiliation: Department of Respiratory medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, Zhejiang 310016, China.
authors.forename: Ruifeng
authors.initials: R
authors.lastname: Zhang
authors.forename: Fangchun
authors.initials: F
authors.lastname: Shao
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Wu
authors.forename: Kejing
authors.initials: K
authors.lastname: Ying
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D004247:DNA / Q000097:blood*; D055088:Early Detection of Cancer / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay; D005470:Fluorometry; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D004247:DNA