Meta-analysis Of CtDNA For The Detection Of EGFR Mutation In Advanced Non-small Lung Cancer Patients

Objective:Investigate the diagnostic value of ctDNA for the detection of EGFR mutation in advanced non-small lung cancer patients By meta analysis.Methods:We retrieve multiple Chinese and English databases to identify eligible studies which reported the sensitivity and specificity of ctDNA for detection of EGFR mutation status in advanced NSCLC.Overall diagnostic performance of the test were evaluated by pooled sensitiveness,specificity,likelihood ratio scattergram,SROC and AUC.Results :Twenty eight eligible studies involving 3644 participants were included.The pooled sensitiveness and specificity of ctDNA detection of EGFR gene mutation were 64%(95%CI:0.59 ~ 0.70),98%(95%CI:0.95~0.99),suggesting an average misdiagnosis rate of 2% and an average missed diagnosis rate of 36%.SROC area under the curve was 0.85(95%CI:0.82~0.88),.indicating the higher accuracy of ctDNA.Conclusion:ctDNA is a highly specific and effective biomarker for the detection of EGFR mutation in advanced non-small lung cancer patients,and ctDNA biopsy in tumor gene spectrum dynamic follow-up and overcome time and space heterogeneity has unique advantages,ctDNA will be a key part of personalized cancer therapy of advanced NSCLC.