Meta-Analysis of the Diagnostic Value of Cell-free DNA for Renal Cancer

Cell-free DNA (cf-DNA) has been reported to represent a suitable material for liquid biopsy in the diagnosis and prognosis of various cancers. We performed a meta-analysis of published data to investigate the diagnostic value of cf-DNA for renal cancer (RCa). Systematic searches were conducted using Pubmed, Embase databases, Web of Science, Medline and Cochrane Library to identify relevant publications until the 31st March 2021. For all patients, we evaluated the true diagnostic value of cf-DNA by calculating the number of true positive, false positive, true negative, and false negative, diagnoses by extracting specificity and sensitivity data from the selected literature. In total, 8 studies, featuring 754 RCa patients, and 355 healthy controls, met our inclusion criteria. The overall diagnostic sensitivity and specificity for cf-DNA was 0.71 (95% confidence interval (CI), 0.55–0.83) and 0.79 (95% CI, 0.66–0.88), respectively. The pooled positive likelihood ratio and pooled negative likelihood ratio were 3.42 (95% CI, 2.04–5.72) and 0.36 (95% CI, 0.23–0.58), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79–0.85), and the diagnostic odds ratio was 7.80 (95% CI, 4.40–13.85). Collectively, our data demonstrate that cf-DNA has high specificity and sensitivity for diagnosing RCa. Therefore, cf-DNA is a useful biomarker for the diagnosis of RCa.

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Differential Diagnostic Value of Bilateral Inferior Petrosal Sinus Sampling (BIPSS) in ACTH-Dependent Cushing Syndrome: a Systematic Review and Meta-Analysis

10.21203/rs.2.21469/v1 ◽

2020 ◽

Author(s):

Hao Wang ◽

Ying Ba ◽

Qian Xing ◽

Run-Ce Cai

Keyword(s):

Differential Diagnosis ◽

Likelihood Ratio ◽

Cushing Syndrome ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Published Data ◽

Inferior Petrosal Sinus ◽

Inferior Petrosal Sinus Sampling ◽

Sensitivity Specificity

Abstract Background: Previous studies have shown inconsistent results in the differential diagnosis obtained from bilateral inferior petrosal sinus sampling (BIPSS) in adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature. Methods: This study searched PubMed, Embase, Web of Science, the Cochrane library, and the Wanfang database for published data on the differential diagnosis obtained using BIPSS in Cushing syndrome as of October 2019. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves were calculated based on the relevant data. Results: This meta-analysis included a total of 23 studies with 1,617 patients. The calculated sensitivity, specificity, PLR, and NLR were 0.94 (95% confidence interval, CI: 0.91–0.96), 0.89 (95% CI: 0.79–0.95), 8.8 (95% CI: 4.3–17.9), and 0.07 (95% CI: 0.04–0.11), respectively. The pooled DOR and area under the ROC curve were 129 (95% CI: 48–345) and 0.97 (95% CI: 0.95–0.98), respectively. Conclusion: This meta-analysis indicated that BIPSS had a highly diagnostic value for ACTH originally in patients with ACTH-dependent Cushing syndrome, and BIPSS should be used as a routine method to identify ACTH sources. Keywords: Bilateral inferior petrosal sinus sampling, ACTH-dependent Cushing syndrome, Differential diagnosis , Diagnostic meta-analysis

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Differential diagnostic value of bilateral inferior Petrosal sinus sampling (BIPSS) in ACTH-dependent Cushing syndrome: a systematic review and Meta-analysis

BMC Endocrine Disorders ◽

10.1186/s12902-020-00623-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hao Wang ◽

Ying Ba ◽

Qian Xing ◽

Run-Ce Cai

Keyword(s):

Differential Diagnosis ◽

Likelihood Ratio ◽

Cushing Syndrome ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Published Data ◽

Inferior Petrosal Sinus ◽

Inferior Petrosal Sinus Sampling ◽

Sensitivity Specificity

Abstract Background Previous studies have shown inconsistent results about the usefulness of bilateral inferior petrosal sinus sampling (BIPSS) in differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature. Methods This study searched PubMed, Embase, Web of Science, Cochrane library, and Wanfang database for published data on the use of BIPSS in Cushing syndrome differential diagnosis as of October 2019. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves were calculated based on the relevant data. Results This meta-analysis included a total of 23 studies with 1642 patients. The calculated sensitivity, specificity, PLR, and NLR were 0.94 (95% confidence interval, CI: 0.91–0.96), 0.89 (95% CI: 0.79–0.95), 8.8 (95% CI: 4.3–17.9), and 0.07 (95% CI: 0.04–0.11), respectively. The pooled DOR and area under the ROC curve were 129 (95% CI: 48–345) and 0.97 (95% CI: 0.95–0.98), respectively. Conclusion This meta-analysis indicated that BIPSS had high diagnostic value for detecting ACTH in patients with ACTH-dependent Cushing syndrome, and BIPSS should be used as an effective method to identify ACTH-secretion sources.

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Differential Diagnostic Value of Bilateral Inferior Petrosal Sinus Sampling (BIPSS) in ACTH-Dependent Cushing Syndrome: a Systematic Review and Meta-Analysis

10.21203/rs.2.21469/v3 ◽

2020 ◽

Author(s):

Hao Wang ◽

Ying Ba ◽

Qian Xing ◽

Run-Ce Cai

Keyword(s):

Differential Diagnosis ◽

Likelihood Ratio ◽

Cushing Syndrome ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Published Data ◽

Inferior Petrosal Sinus ◽

Inferior Petrosal Sinus Sampling ◽

Sensitivity Specificity

Abstract Background: Previous studies have shown inconsistent results about the usefulness of bilateral inferior petrosal sinus sampling (BIPSS) in differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature.Methods: This study searched PubMed, Embase, Web of Science, Cochrane library, and Wanfang database for published data on the use of BIPSS in Cushing syndrome differential diagnosis as of October 2019. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves were calculated based on the relevant data.Results: This meta-analysis included a total of 23 studies with 1,617 patients. The calculated sensitivity, specificity, PLR, and NLR were 0.94 (95% confidence interval, CI: 0.91–0.96), 0.89 (95% CI: 0.79–0.95), 8.8 (95% CI: 4.3–17.9), and 0.07 (95% CI: 0.04–0.11), respectively. The pooled DOR and area under the ROC curve were 129 (95% CI: 48–345) and 0.97 (95% CI: 0.95–0.98), respectively.Conclusion: This meta-analysis indicated that BIPSS had high diagnostic value for detecting ACTH in patients with ACTH-dependent Cushing syndrome, and BIPSS should be used as an effective method to identify ACTH-secretion sources.

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The Diagnostic Value of Soluble ST2 in Heart Failure: A Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.685904 ◽

2021 ◽

Vol 8 ◽

Author(s):

Chaojun Yang ◽

Zhixing Fan ◽

Jinchun Wu ◽

Jing Zhang ◽

Wei Zhang ◽

...

Keyword(s):

Heart Failure ◽

Publication Bias ◽

Likelihood Ratio ◽

Meta Analysis ◽

False Negative ◽

Positive Likelihood Ratio ◽

Threshold Effect ◽

Diagnostic Value ◽

Cochrane Library ◽

Spearman Correlation

Objective: The diagnostic performance of soluble suppression of tumorigenicity (sST2) in heart failure (HF) had been investigated in multiple studies, but the results were inconsistent. This meta-analysis evaluated the diagnostic value of sST2 in HF.Methods: Pubmed, Web of Science, Embase, and Cochrane Library databases were searched until March 2021. Cohort studies or case-control studies relevant to the diagnostic value of sST2 in HF were screened, and true positive (TP), false positive (FP), false negative (FN), and true negative (TN) data were extracted for calculating sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC). The quality of the included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS), the threshold effect was determined by calculating Spearman correlation coefficients and summary receiver operating characteristic (SROC) curve patterns, the heterogeneity was evaluated using the I2 statistic and the Galbraith radial plot, and sensitivity analysis was also performed. Deeks' test was used to assess publication bias.Results: A total of 11 studies from 10 articles were included in this meta-analysis. The Spearman correlation coefficient was 0.114, p = 0.739, and the SROC curve did not show a “shoulder-arm” shape, which suggests that there was no threshold effect, but study heterogeneity existed because of non-threshold effects. The combined sensitivity was 0.72 [95% confidence interval (CI): 0.65–0.78], specificity was 0.65 (95% CI: 0.45–0.81), PLR was 1.75 (95% CI: 1.33–2.31), NLR was 0.48 (95% CI: 0.37–0.63), DOR was 3.63 (95% CI: 2.29–5.74), and AUC was 0.75. The Deeks' test suggested no significant publication bias in the included studies (P = 0.94).Conclusion: sST has some diagnostic value in HF, but this should be further evaluated in additional studies with rigorous design and high homogeneity.

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Differential Diagnostic Value of Bilateral Inferior Petrosal Sinus Sampling (BIPSS) in ACTH-Dependent Cushing Syndrome: a Systematic Review and Meta-Analysis

10.21203/rs.2.21469/v2 ◽

2020 ◽

Author(s):

Hao Wang ◽

Ying Ba ◽

Qian Xing ◽

Run-Ce Cai

Keyword(s):

Differential Diagnosis ◽

Likelihood Ratio ◽

Cushing Syndrome ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Published Data ◽

Inferior Petrosal Sinus ◽

Inferior Petrosal Sinus Sampling ◽

Sensitivity Specificity

Abstract Background: Previous studies have shown inconsistent results about the usefulness of bilateral inferior petrosal sinus sampling (BIPSS) in differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature.Methods: This study searched PubMed, Embase, Web of Science, Cochrane library, and Wanfang database for published data on the use of BIPSS in Cushing syndrome differential diagnosis as of October 2019. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves were calculated based on the relevant data.Results: This meta-analysis included a total of 23 studies with 1,617 patients. The calculated sensitivity, specificity, PLR, and NLR were 0.94 (95% confidence interval, CI: 0.91–0.96), 0.89 (95% CI: 0.79–0.95), 8.8 (95% CI: 4.3–17.9), and 0.07 (95% CI: 0.04–0.11), respectively. The pooled DOR and area under the ROC curve were 129 (95% CI: 48–345) and 0.97 (95% CI: 0.95–0.98), respectively.Conclusion: This meta-analysis indicated that BIPSS had high diagnostic value for detecting ACTH in patients with ACTH-dependent Cushing syndrome, and BIPSS should be used as a routine method to identify ACTH-secretion sources.

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Differential Diagnostic Value of Bilateral Inferior Petrosal Sinus Sampling (BIPSS) in ACTH-Dependent Cushing Syndrome: a Systematic Review and Meta-Analysis

10.21203/rs.2.21469/v4 ◽

2020 ◽

Author(s):

Hao Wang ◽

Ying Ba ◽

Qian Xing ◽

Run-Ce Cai

Keyword(s):

Differential Diagnosis ◽

Likelihood Ratio ◽

Cushing Syndrome ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Published Data ◽

Inferior Petrosal Sinus ◽

Inferior Petrosal Sinus Sampling ◽

Sensitivity Specificity

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The diagnostic value of 11C-methionine PET in hyperparathyroidism with negative 99mTc-MIBI SPECT: a meta-analysis

Acta Radiologica ◽

10.1177/0284185116661878 ◽

2016 ◽

Vol 58 (5) ◽

pp. 558-564 ◽

Cited By ~ 10

Author(s):

Leilei Yuan ◽

Jun Liu ◽

Ying Kan ◽

Jigang Yang ◽

Xufu Wang

Keyword(s):

Sensitivity And Specificity ◽

Meta Analysis ◽

False Negative ◽

Total Sample ◽

Diagnostic Value ◽

Published Data ◽

Diagnostic Modality ◽

Positron Emission ◽

99Mtc Mibi ◽

Mibi Spect

Background 99mTc-sestamibi (MIBI) parathyroid SPECT is generally regarded as the best preoperative localizing method in patients with hyperparathyroidism (HPT). However, 99mTc-MIBI SPECT is false negative in approximately 25% of adenomas. 11C-methionine positron emission tomography (PET) has been used in HPT with negative 99mTc-MIBI SPECT scan results. Purpose To systematically review and conduct a meta-analysis of published data on the performance of 11C-methionine PET in patients with HPT with negative 99mTc-MIBI SPECT. Material and Methods A comprehensive review of the literature was performed. Pooled sensitivity and specificity of 11C-methionine PET in patients with HPT and a negative 99mTc-MIBI SPECT was calculated on a per-patient basis using receiver-operating characteristic (ROC) methodology. Results Nine studies that met all inclusion and exclusion criteria were included into our meta-analysis, comprising a total sample size of 137 patients. Pooled sensitivity and specificity of 11C-methionine PET in patients with HPT with negative or inconclusive 99mTc-MIBI SPECT scans was 86% and 86%, respectively. The area under the ROC curve was 0.87. Conclusion By merit of the high overall sensitivity, specificity, and accuracy, 11C-methionine PET can potentially complement the diagnostic workup of patients with HPT and negative or inconclusive 99mTc-MIBI SPECT. 11C-methionine PET appears to be a promising diagnostic modality in complicated cases with HPT.

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Quantitative and Qualitative Analysis of Circulating Cell-Free DNA Can Be Used as an Adjuvant Tool for Prostate Cancer Screening: A Meta-Analysis

Disease Markers ◽

10.1155/2016/3825819 ◽

2016 ◽

Vol 2016 ◽

pp. 1-12 ◽

Cited By ~ 7

Author(s):

Changqing Yin ◽

Changliang Luo ◽

Wei Hu ◽

Xu Ding ◽

Chunhui Yuan ◽

...

Keyword(s):

Prostate Cancer ◽

Qualitative Analysis ◽

Prostate Cancer Screening ◽

Meta Analysis ◽

Specific Antigen ◽

Diagnostic Value ◽

Qualitative Assessment ◽

Cell Free Dna ◽

Free Dna ◽

Circulating Cell Free Dna

As part of “liquid biopsy,” lots of literature indicated the potential diagnostic value of circulating cell-free DNA (cfDNA) in the management of prostate cancer (PCa). However, the literature on the accuracy of cfDNA detection in PCa has been inconsistent. Hence, we performed this meta-analysis to assess the diagnostic value of cfDNA in PCa. A total of 19 articles were included in this analysis according to the inclusion and exclusion criteria. We then investigated two main subgroups in this meta-analysis, including qualitative analysis of abnormal level of cfDNA and qualitative analysis of single-gene methylation alterations. Overall, the results of quantitative analysis showed sensitivity of 0.73 (95% CI, 0.62–0.82) and specificity of 0.80 (95% CI, 0.70–0.87), with an area under the curve (AUC) of 0.83 (95% CI, 0.80–0.86). For qualitative assessment, the values were 0.34 (95% CI, 0.22–0.48), 0.99 (95% CI, 0.97–1.00), and 0.91 (95% CI, 0.88–0.93), respectively. Our results suggest the pooled specificity of each subgroup is much higher than the specificity of prostate-specific antigen (PSA). However, they are not recommended for PCa screening alone, because their sensitivities are not higher than the conventional serum biomarkers PSA. We conclude that analysis of cfDNA can be used as an adjuvant tool for PCa screening.

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The diagnostic value of D-dimer in acute aortic dissection: a meta-analysis

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01726-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jian Yao ◽

Tao Bai ◽

Bo Yang ◽

Lizhong Sun

Keyword(s):

Aortic Dissection ◽

Likelihood Ratio ◽

Acute Aortic Dissection ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Diagnostic Value ◽

Cochrane Library ◽

Operating Characteristics ◽

Meta Regression ◽

D Dimer

Abstract Objective This study aims to evaluate the diagnostic value of D-dimer for acute aortic dissection (AAD) by the method of meta-analysis. Methods PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases from the establishment of the databases to December 2020 were systematically searched, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) system was used to evaluate the quality of the literature. STATA 15.0 software was applied to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), negative likelihood ratio (−LR) to draw summary receiver operating characteristics (SROC) curve and calculate the area under the curve (AUC). Meta-regression and subgroup analyses were used to explore the source of heterogeneity. Results A total of 16 clinical studies were enrolled in this study, including 1135 patients. The results of the meta-analysis showed that the pooled sensitivity was 0.96 (95% CI 0.91–0.98), the pooled specificity was 0.70 (95% CI 0.57–0.81), and the pooled DOR was 56.57 (95% CI 25.11–127.44), the pooled +LR was 3.25 (95% CI 2.18–4.85), the pooled −LR was 0.06 (95% CI 0.03–0.12), and the AUC was 0.94 (95% CI 0.91–0.95). Meta-regression and subgroup analysis results showed that publication year, sample size and cutoff value might be sources of heterogeneity. When the concentration of D-dimer was less than or equal to 500 ng/ml, the sensitivity significantly increased. Conclusion D-dimer has an excellent diagnostic value for AAD. It is a useful tool for detecting suspected AAD because of the excellent pooled sensitivity. D-dimer ≤ 500 ng/ml increases the potential to identify the suspected patients with AAD.

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Identification of circulating microRNAs as diagnostic biomarkers for ovarian cancer: A pooled analysis of individual studies

The International Journal of Biological Markers ◽

10.1177/1724600818766500 ◽

2018 ◽

Vol 33 (4) ◽

pp. 379-388 ◽

Cited By ~ 2

Author(s):

Quan Zhou ◽

Man-Zhen Zuo ◽

Ze He ◽

Hai-Rong Li ◽

Wei Li

Keyword(s):

Ovarian Cancer ◽

Likelihood Ratio ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Diagnostic Value ◽

Cochrane Library ◽

Circulating Mirnas ◽

Diagnostic Biomarkers ◽

Circulating Micrornas ◽

Diagnostic Characteristics

Background: Circulating microRNAs (miRNAs) are proposed as promising non-invasive diagnostic biomarkers for many cancers. However, the diagnostic value of circulating miRNAs in ovarian cancer is inconsistent in different studies. Thus we performed this meta-analysis to systematically evaluate the diagnostic value of circulating miRNAs in ovarian cancer. Methods: Eligible studies that were published prior to 30 June 2017 were searched from the PubMed, EMBASE, Cochrane Library, and Chinese National Knowledge Infrastructure. All analyses were performed using STATA 12.0 software. A bivariate regression was used to calculate pooled diagnostic accuracy estimates. Results: A total of 36 studies from 16 publications were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of circulating miRNAs for ovarian cancer diagnosis were 0.76 (95% confidence intervals (CI): 0.69, 0.81), 0.81 (95% CI 0.74, 0.87), 4.00 (95% CI 2.70, 5.30), 0.30(95% CI 0.24, 0.37) and 13.00 (95% CI 9.00, 19.00), respectively. The area under the summary receiver operating characteristic curve was 0.85 (95% CI 0.82, 0.88). Subgroup analyses showed that multiple miRNA assays yielded better diagnostic characteristics than a single miRNA assay, and plasma miRNAs were better than serum miRNAs for ovarian cancer detection. Conclusion: Circulating miRNAs, especially the combination of multiple circulating miRNAs, are promising biomarkers for the diagnosis of ovarian cancer. However, further large-scale prospective studies are necessary to validate the applicability of the miRNAs in the early detection of ovarian cancer.

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