title: Diagnostic Performance of DNA Hypermethylation Markers in Peripheral Blood for the Detection of Colorectal Cancer: A Meta-Analysis and Systematic Review.
abstract: DNA hypermethylation in blood is becoming an attractive candidate marker for colorectal cancer (CRC) detection. To assess the diagnostic accuracy of blood hypermethylation markers for CRC in different clinical settings, we conducted a meta-analysis of published reports. Of 485 publications obtained in the initial literature search, 39 studies were included in the meta-analysis. Hypermethylation markers in peripheral blood showed a high degree of accuracy for the detection of CRC. The summary sensitivity was 0.62 [95% confidence interval (CI), 0.56-0.67] and specificity was 0.91 (95% CI, 0.89-0.93). Subgroup analysis showed significantly greater sensitivity for the methylated Septin 9 gene (SEPT9) subgroup (0.75; 95% CI, 0.67-0.81) than for the non-methylated SEPT9 subgroup (0.58; 95% CI, 0.52-0.64). Sensitivity and specificity were not affected significantly by target gene number, CRC staging, study region, or methylation analysis method. These findings show that hypermethylation markers in blood are highly sensitive and specific for CRC detection, with methylated SEPT9 being particularly robust. The diagnostic performance of hypermethylation markers, which have varied across different studies, can be improved by marker optimization. Future research should examine variation in diagnostic accuracy according to non-neoplastic factors.
authors.affiliation: Department of Gastroenterology, Huizhou First Hospital, Huizhou, 516003, China.
authors.forename: Bingsheng
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, Huizhou First Hospital, Huizhou, 516003, China.
authors.forename: Aihua
authors.initials: A
authors.lastname: Gan
authors.affiliation: Department of Gastroenterology, Hainan provincial people's Hospital, Haikuo, 570100, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
authors.forename: Xinying
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Huizhou First Hospital, Huizhou, 516003, China.
authors.forename: Weifeng
authors.initials: W
authors.lastname: He
authors.affiliation: Department of Gastroenterology, Huizhou First Hospital, Huizhou, 516003, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Huizhou Medicine Institute, Huizhou First Hospital, Huizhou, 516003, China.
authors.forename: Renxiang
authors.initials: R
authors.lastname: Huang
authors.affiliation: Huizhou Medicine Institute, Huizhou First Hospital, Huizhou, 516003, China.
authors.forename: Shuzhu
authors.initials: S
authors.lastname: Zhou
authors.affiliation: School of Public Health, Kunming Medical University, Kunming, 650500, China.
authors.forename: Xiaoxiao
authors.initials: X
authors.lastname: Song
authors.affiliation: Huizhou Medicine Institute, Huizhou First Hospital, Huizhou, 516003, China.
authors.forename: Angao
authors.initials: A
authors.lastname: Xu
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis*; D019175:DNA Methylation; D006801:Humans; D012680:Sensitivity and Specificity; D058112:Septins / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; C474315:SEPTIN9 protein, human; D058112:Septins