title: Effectiveness of circulating tumor DNA for detection of KRAS gene mutations in colorectal cancer patients: a meta-analysis.
abstract: Circulating tumor DNA (ctDNA) can be identified in the peripheral blood of patients and harbors the genomic alterations found in tumor tissues, which provides a noninvasive approach for detection of gene mutations. We conducted this meta-analysis to investigate whether ctDNA can be used for monitoring KRAS gene mutations in colorectal cancer (CRC) patients. Medline, Embase, Cochrane Library and Web of Science were searched for the included eligible studies in English, and data were extracted for statistical analysis according to the numbers of true-positive (TP), true-negative (TN), false-positive (FP) and false-negative (FN) cases. Sensitivity, specificity and diagnostic odds ratio (DOR) were calculated, and the area under the receiver operating characteristic curve (AUROC) was used to evaluate the diagnostic performance. After independent searching and reviewing, 21 studies involving 1,812 cancer patients were analyzed. The overall sensitivity, specificity and DOR were 0.67 (95% confidence interval [CI] =0.55-0.78), 0.96 (95% CI =0.93-0.98) and 53.95 (95% CI =26.24-110.92), respectively. The AUROC was 0.95 (95% CI =0.92-0.96), which indicated the high diagnostic accuracy of ctDNA. After stratified analysis, we found the higher diagnostic accuracy in subgroup of patients detected in blood sample of plasma. The ctDNA may be an ideal source for detection of KRAS gene mutations in CRC patients with high specificity and diagnostic value.
authors.affiliation: Department of Oncology, First Affiliated Hospital.
authors.forename: Yi-Xin
authors.initials: YX
authors.lastname: Hao
authors.affiliation: Department of Anesthesiology, People's Liberation Army General Hospital, Beijing, People's Republic of China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fu
authors.affiliation: Department of Oncology, First Affiliated Hospital.
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Guo
authors.affiliation: Department of Oncology, First Affiliated Hospital.
authors.forename: Ming
authors.initials: M
authors.lastname: Ye
authors.affiliation: Department of Oncology, First Affiliated Hospital.
authors.forename: Hui-Xia
authors.initials: HX
authors.lastname: Zhao
authors.affiliation: Department of Oncology, First Affiliated Hospital.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Oncology, First Affiliated Hospital.
authors.forename: Xiu-Mei
authors.initials: XM
authors.lastname: Peng
authors.affiliation: Department of Oncology, First Affiliated Hospital.
authors.forename: Qiu-Wen
authors.initials: QW
authors.lastname: Li
authors.affiliation: Department of Oncology, First Affiliated Hospital.
authors.forename: Ru-Liang
authors.initials: RL
authors.lastname: Wang
authors.affiliation: Department of Oncology, First Affiliated Hospital.
authors.forename: Wen-Hua
authors.initials: WH
authors.lastname: Xiao
keywords: KRAS; cancer; circulating tumor DNA; mutation