Diagnostic Value Of Ras Association Domain Family 1A Methylation In Peripheral Blood For Hepatocellular Carcinoma:A Meta-Analysis

ObjectiveTo evaluate the diagnostic value of Ras association domain family 1A(RASSF1A)methylation in peripheral blood for hepatocellular carcinoma by meta-analysis.MethodsPeer reviewed papers about RASSF1 A methylation in blood and hepatocellular carcinoma published before October 2019 were searched in Pubmed,EMBASE,Cochrane,Wanfang and CNKI database.Papers were screened and evaluated by using the quality assessment of diagnostic accuracy studies(QUADAS).Then,meta-analysis was performed with Stata 12.0 and MetaDisc1.4 software.Combined statistical indicators including sensitivity(Sen),specificity(Spe),positive likelihood ratio(PLR)and negative likelihood ratio(NLR),diagnostic odds ratio(DOR),area under the curve(AUC)of the summary receiver operating characteristic curve(SROC).The sources of heterogeneity were explored by subgroup analysis,materegression analysis and sensitivity analysis.Results1.After screening and evaluation,11 papers were finally selected,with a total of819 cases of primary liver cancer and 827 cases of control(including chronic hepatitis,cirrhosis and benign liver diseases),of which 1 paper was a prospective study and the others were retrospective case-control studies.2.The pooled sensitivity and specificity of association between RASSF1 A methylation in blood and hepatocellular carcinoma was 0.56(95%CI:0.36~0.74)and0.81(95%CI:0.64~0.92),positive likelihood ratio and negative likelihood ratio was3.0(95%CI:1.5~5.9)and 0.55(95%CI:0.36~0.83),the diagnostic odds ratio was5(95%CI:2~14),the area under SROC curve was 0.75(95%CI:0.71~0.79).3?In this meta-analysis,the heterogeneity was caused by non-threshold effect,but not threshold effect,and mainly comes from two parts including "method" and "prodesign".ConclusionRASSF1A methylation in peripheral blood has a good diagnostic value for HCC.RASSF1 A methylation in peripheral blood is a promising non-invasive biomarker.