title: Is it feasible to detect epidermal growth factor receptor mutations in circulating tumor cells in nonsmall cell lung cancer?: A meta-analysis.
abstract: BACKGROUND
  The value of circulating tumor cells (CTCs) in detecting epidermal growth factor receptor (EGFR) mutations in patients with nonsmall cell lung cancer (NSCLC) is controversial. We performed a meta-analysis to investigate the diagnostic significance of CTCs with tumor tissues as the standard control.
  
  
  METHODS
  A systematic literature search, including papers published until November 26, 2015, was performed using PubMed, Medline, Embase, Web of Science, and the China National Knowledge Infrastructure, and the references of retrieved articles were screened. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated according to the data selection from the included studies. The evaluation indexes of the diagnostic performance were the summary receiver operating characteristic curve (SROC) and area under the SROC (AUSROC).
  
  
  RESULTS
  Eight eligible articles with a total of 170 participants were identified in our meta-analysis. The pooled sensitivity and specificity were 0.91 [95% CI: 0.55-0.99] and 0.99 [95% CI: 0.59-1.00]. The positive likelihood ratio and negative likelihood ratio were 68 [95% CI: 1.4-3364] and 0.09 [95% CI: 0.01-0.64], respectively. The DOR was 788 [95% CI: 9-71884]. The high diagnostic performance of CTCs in detecting EGFR mutations was indicated by the AUSROC of 0.99 [95% CI: 0.98-1.00].
  
  
  CONCLUSIONS
  CTCs are a feasible and highly specific biomarker for detecting the EGFR mutation status in NSCLC patients.
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Southern Medical University Department of Orthopedics Medicine, Jinling Hospital, Southern Medical University, Nanjing, China.
authors.forename: Yafang
authors.initials: Y
authors.lastname: Liu
authors.forename: Ze
authors.initials: Z
authors.lastname: Xing
authors.forename: Ping
authors.initials: P
authors.lastname: Zhan
authors.forename: Hongbing
authors.initials: H
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Ye
authors.forename: Tangfeng
authors.initials: T
authors.lastname: Lv
authors.forename: Yong
authors.initials: Y
authors.lastname: Song
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics*; D066246:ErbB Receptors / Q000235:genetics*; D008175:Lung Neoplasms / Q000235:genetics*; D009154:Mutation; D009360:Neoplastic Cells, Circulating
chemical_list: D014408:Biomarkers, Tumor; D066246:ErbB Receptors