Diagnostic and prognostic value of blood samples for KRAS mutation identification in lung cancer: a meta-analysis
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Hongchang Shen1,*, Keying Che2,*, Lei Cong1, Wei Dong3 , Tiehong Zhang1, Qi Liu2 and Jiajun Du2,3
1 Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, P.R. China
2 Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, P.R. China
3 Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, P.R. China
* These authors have contributed equally to this work
Jiajun Du, email:
Qi Liu, email:
Keywords: lung cancer; blood; KRAS; diagnostic test; predictive factor
Received: October 09, 2016 Accepted: February 28, 2017 Published: March 07, 2017
Circulating tumor DNA (ctDNA) and tumor cells (CTC) are novel approaches for identifying genomic alterations. Thus, we designed a meta-analysis to evaluate the diagnostic value and prognostic significance of a KRAS proto-oncogene, GTPase (KRAS) mutation for lung cancer patients. All included articles were from PubMed, EMBASE, Web of Science and Cochrane Library. Twelve articles that described 1,131 patients were reviewed. True positives (TP), false positives (FP), true negatives (TN), and false negatives (FN) were used to calculate pooled sensitivity, specificity, the positive likelihood ratio (PLR), the negative likelihood ratio (NLR), a diagnostic odds ratio (DOR), the area under the curve (AUC) and corresponding 95% confidence intervals (95% CI). PLR is calculated as sensitivity/(1-specificity) and NLR is (1– sensitivity)/specificity. DOR is a measured of diagnostic effectiveness (PLR/NLR). A survival analysis subgroup was also designed to evaluate prognostic significance. Pooled sensitivity, specificity, PLR, NLR, DOR and AUC were 0.79 (95% CI, 0.63-0.89), 0.93 (95% CI, 0.89-0.96), 12.13 (92% CI, 7.11-20.67), 0.22 (95% CI, 0.12-0.41), 54.82 (95% CI, 23.11-130.09), and 0.95 (95% CI, 0.93–0.96), respectively. KRAS mutation and wild-type hazard ratios for overall survival and progression-free survival were 1.37 (95% CI, 1.08–1.66), 1.46 (95% CI, 1.15-1.77) in blood samples, and 1.16 (95% CI, 1.03–1.28), 1.28 (95% CI, 1.09–1.46) in tumor tissue.
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