Diagnostic Value Of Circulating Tumor DNA For Determination Of KRAS Mutation In Colorectal Cancer: A Meta-analysis

Objective: To systematically evaluate the diagnostic value of circulating tumor DNA for determination of KRAS gene mutation in colorectal cancerMethods: Relevant studies were identified by searching Pub Med,EMBASE,Cochrane Library,CNKI,Wanfang database,Chinese biomedical database for key words such as colorectal neoplasm / colorectal cancer,circulating tumor DNA / ctDNA / circulating tumor DNA,KRAS / KRAS gene.The included studies were selected in strict accordance with the inclusion and exclusion criteria.The quality assessment of diagnostic accuracy study 2(quadas-2)was used to evaluate the quality of the literature.Statistical analysis were conducted with the Review Manager Software 5.3,Stata 15.0and meta disc 1.4.Funnel plot,forest plot and summary receiver operating characteristic(SROC)curve were made to evaluate the diagnostic value of ctDNA for determination of KRAS gene mutation in colorectal cancer.Results: A total of 1533 articles were searched,and 20 articles were included according to the inclusion and exclusion criteria,including 21 groups of data.The combined sensitivity was 0.72(95%CI:0.62,0.80),the combined specificity was 0.95(95%CI:0.92,0.97).The likelihood ratio,negative likelihood ratio and area under the SROC curve of the KRAS gene mutation determined by peripheral blood ctDNA were 37.84(95%CI:20.31,70.52),0.31(95%CI:0.23,0.42),and 0.93(95%CI:0.91,0.95).Conclusions: ctDNA shows a concise,timely and relatively high specific diagnostic value for the detection of KRAS gene mutations in colorectal cancer.It can be better used for clinical diagnosis of colorectal cancer and guide targeted therapy based on genetic status.