Value Of Circulating Tumor Cells For Diagnosis Of Ovarian Cancer:A Meta-analysis

Objectives: Ovarian cancer is the main cause of cancer-related death in gynecological malignancies.In order to find new biomarkers for the diagnosis and prognosis of ovarian cancer,we conducted a meta-analysis to evaluate the diagnostic value of circulating tumor cells in ovarian cancer.Methods: The literatures were searched extensively through a broad range of databases,including PubMed,Embase,Cochrane Library,CNKI,CBM and Wan Fang Database,two investigators performed literature screening,data extraction and quality evaluation.Sensitivity,specificity,positive likelihood ratio(PLR),negative likelihood ratio(NLR),diagnostic odds ratio(DOR),Summary receiver operating characteristic curves(SROC)and Area under the curve(AUC)were used to evaluate the diagnostic value.Fagan diagram was used to evaluate the clinical value of circulating tumor cells.Subgroup analysis and meta regression analysis were used to explore the sources of heterogeneity.Stata 15.1 and meta disk 1.4 software were used to analyze the data.Results: A total of 15 studies were finally meta-analyzed,including 769 patients and 1038 controls.The sensitivity of the combination was 0.69(95% CI: 0.65-0.72),the specificity was 0.907(95% CI: 0.96-0.98),the positive likelihood ratio was 24.47(95% CI: 5.35-112.02),and the negative likelihood ratio was 0.31(95% CI:0.22-0.44).In addition,the DOR of ovarian cancer was 82.95(95% CI: 28.19-244.06).The area under SROC curve is 0.8958.Conclusion: 1.CTCs has high diagnostic performance for ovarian cancer;2.the immunological separation method has higher diagnostic ratio of ovarian cancer than morphological separation method;3.nucleic acid detection method are better than the cell counting method,it is difficult to determine the diagnostic value of nucleic acid detection method for ovarian cancer.