title: Colorectal cancer: using blood samples and tumor tissue to detect K-ras mutations.
abstract: We performed a meta-analysis to assess whether blood can be substituted for tumor tissue in K-ras mutation testing. PubMed, EMBASE, MEDLINE, and BIOSIS databases were searched. Twenty-three studies including 1261 patients were included. The pooled overall sensitivity, specificity, and concordance rate were 0.69 (95% CI: 0.59-0.78), 0.96 (95% CI: 0.93-0.97), and 0.86 (95% CI: 0.82-0.89), respectively. Subgroup analysis indicated that plasma (sensitivity: 0.74; mutation rate: 0.34) exhibited superior sensitivity compared with serum (sensitivity: 0.45; mutation rate: 0.24). We conclude that blood is a suitable substitute for tumor tissue in K-ras mutation testing. K-ras mutation positivity in blood can be used to identify patients who should not receive EGFR monoclonal antibody therapy, but the absence of blood positivity does not necessarily imply negativity.
authors.affiliation: Center of Injury Prevention and Control, Medical College of Jinan University, Guangzhou, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Fu
authors.forename: Jin-Qiu
authors.initials: JQ
authors.lastname: Yuan
authors.forename: Zu-Yao
authors.initials: ZY
authors.lastname: Yang
authors.forename: Chen
authors.initials: C
authors.lastname: Mao
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Dong
authors.forename: Jin-Ling
authors.initials: JL
authors.lastname: Tang
authors.forename: Sheng-Yong
authors.initials: SY
authors.lastname: Wang
mesh_terms: D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D011905:Genes, ras / Q000235:genetics*; D006801:Humans; D009154:Mutation; D012680:Sensitivity and Specificity
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D066246:ErbB Receptors
keywords: K-ras; blood; colorectal cancer; diagnostic test; meta-analysis; mutation; plasma; serum