Accuracy of early detection of colorectal tumours by stool methylation markers: a meta-analysis

World J Gastroenterol. 2014 Oct 14;20(38):14040-50. doi: 10.3748/wjg.v20.i38.14040.

Abstract

Aim: To evaluate the accuracy of methylation of genes in stool samples for diagnosing colorectal tumours.

Methods: Electronic databases including PubMed, Web of Science, Chinese Journals Full-Text Database and Wanfang Journals Full-Text Database were searched to find relevant original articles about methylated genes to be used in diagnosing colorectal tumours. A quality assessment of diagnostic accuracy studies tool (QADAS) was used to evaluate the quality of the included articles, and the Meta-disc 1.4 and SPSS 13.0 software programs were used for data analysis.

Results: Thirty-seven articles met the inclusion criteria, and 4484 patients were included. The sensitivity and specificity for the detection of colorectal cancer (CRC) were 73% (95%CI: 71%-75%) and 92% (95%CI: 90%-93%), respectively. For adenoma, the sensitivity and specificity were 51% (95%CI: 47%-54%) and 92% (95%CI: 90%-93%), respectively. Pooled diagnostic performance of SFRP2 methylation for CRC provided the following results: the sensitivity was 79% (95%CI: 75%-82%), the specificity was 93% (95%CI: 90%-96%), the diagnostic OR was 47.57 (95%CI: 20.08-112.72), the area under the curve was 0.9565. Additionally, the results of accuracy of SFRP2 methylation for detecting colorectal adenomas were as follows: sensitivity was 43% (95%CI: 38%-49%), specificity was 94% (95%CI: 91%-97%), the diagnostic OR was 11.06 (95%CI: 5.77-21.18), and the area under the curve was 0.9563.

Conclusion: Stool-based DNA testing may be useful for noninvasively diagnosing colorectal tumours and SFRP2 methylation is a promising marker that has great potential in early CRC diagnosis.

Keywords: Colorectal adenoma; Colorectal carcinoma; Meta-analysis; Methylation; Stool.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adenoma / genetics*
  • Adenoma / pathology
  • Biomarkers, Tumor / genetics*
  • Carcinoma / genetics*
  • Carcinoma / pathology
  • Chi-Square Distribution
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / pathology
  • DNA Methylation*
  • Early Detection of Cancer / methods*
  • Feces / chemistry*
  • Genetic Testing*
  • Humans
  • Membrane Proteins / genetics
  • Odds Ratio
  • Predictive Value of Tests
  • Reproducibility of Results
  • Risk Factors

Substances

  • Biomarkers, Tumor
  • Membrane Proteins
  • SFRP2 protein, human