title: Accuracy of early detection of colorectal tumours by stool methylation markers: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the accuracy of methylation of genes in stool samples for diagnosing colorectal tumours.
  
  
  METHODS
  Electronic databases including PubMed, Web of Science, Chinese Journals Full-Text Database and Wanfang Journals Full-Text Database were searched to find relevant original articles about methylated genes to be used in diagnosing colorectal tumours. A quality assessment of diagnostic accuracy studies tool (QADAS) was used to evaluate the quality of the included articles, and the Meta-disc 1.4 and SPSS 13.0 software programs were used for data analysis.
  
  
  RESULTS
  Thirty-seven articles met the inclusion criteria, and 4484 patients were included. The sensitivity and specificity for the detection of colorectal cancer (CRC) were 73% (95%CI: 71%-75%) and 92% (95%CI: 90%-93%), respectively. For adenoma, the sensitivity and specificity were 51% (95%CI: 47%-54%) and 92% (95%CI: 90%-93%), respectively. Pooled diagnostic performance of SFRP2 methylation for CRC provided the following results: the sensitivity was 79% (95%CI: 75%-82%), the specificity was 93% (95%CI: 90%-96%), the diagnostic OR was 47.57 (95%CI: 20.08-112.72), the area under the curve was 0.9565. Additionally, the results of accuracy of SFRP2 methylation for detecting colorectal adenomas were as follows: sensitivity was 43% (95%CI: 38%-49%), specificity was 94% (95%CI: 91%-97%), the diagnostic OR was 11.06 (95%CI: 5.77-21.18), and the area under the curve was 0.9563.
  
  
  CONCLUSIONS
  Stool-based DNA testing may be useful for noninvasively diagnosing colorectal tumours and SFRP2 methylation is a promising marker that has great potential in early CRC diagnosis.
authors.affiliation: Hu Zhang, Jian Qi, Qi-Xian Wang, You-Qing Zhu, Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Hu Zhang, Jian Qi, Qi-Xian Wang, You-Qing Zhu, Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Qi
authors.affiliation: Hu Zhang, Jian Qi, Qi-Xian Wang, You-Qing Zhu, Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Ya-Qiong
authors.initials: YQ
authors.lastname: Wu
authors.affiliation: Hu Zhang, Jian Qi, Qi-Xian Wang, You-Qing Zhu, Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Hu Zhang, Jian Qi, Qi-Xian Wang, You-Qing Zhu, Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Hu Zhang, Jian Qi, Qi-Xian Wang, You-Qing Zhu, Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Qi-Xian
authors.initials: QX
authors.lastname: Wang
authors.affiliation: Hu Zhang, Jian Qi, Qi-Xian Wang, You-Qing Zhu, Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: You-Qing
authors.initials: YQ
authors.lastname: Zhu
mesh_terms: D000236:Adenoma / Q000235:genetics* / Q000473:pathology; D014408:Biomarkers, Tumor / Q000235:genetics*; D002277:Carcinoma / Q000235:genetics* / Q000473:pathology; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000473:pathology; D019175:DNA Methylation; D055088:Early Detection of Cancer / Q000379:methods*; D005243:Feces / Q000737:chemistry*; D005820:Genetic Testing; D006801:Humans; D008565:Membrane Proteins / Q000235:genetics; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012307:Risk Factors; D000094742:Secreted Frizzled-Related Proteins
chemical_list: D014408:Biomarkers, Tumor; D008565:Membrane Proteins; C109618:SFRP2 protein, human; D000094742:Secreted Frizzled-Related Proteins
keywords: Colorectal adenoma; Colorectal carcinoma; Meta-analysis; Methylation; Stool