Diagnostic value of circulating cell-free DNA for renal cell carcinoma: a meta-analysis

BACKGROUND: Our meta-analysis was established for evaluating the diagnostic value of circulating cell-free DNA (cfDNA) in renal cell carcinoma (RCC) for the first time. METHODS: The whole relevant publications published by October 30, 2020 were searched based on multiple databases, including the PubMed, Web of Science, Embase, Cochrane Library and China National Knowledge Infrastructure (CNKI). Two major subgroups were investigated: the quantitative cfDNA analysis subgroup and the qualitative cfDNA analysis subgroup. The pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) as well as the area under the curve (AUC) were estimated to evaluate the diagnostic value. RESULTS: A total of eight qualified papers published between 2008 and 2020 were selected into this report. The pooled SEN, SPE, and DOR in quantitative analysis subgroup was 0.59 [95% confidence interval (95% CI): 0.55-0.63], 0.88 (95% CI: 0.85-0.91), 9.98 (95% CI: 5.64-17.69), yielding an AUC of 0.784. In the qualitative analysis subgroup, the corresponding value was 0.47 (95% CI: 0.43-0.52), 0.92 (95% CI: 0.88-0.94), 8.83 (95% CI: 5.64-13.84) and 0.774, respectively. CONCLUSIONS: Circulating cfDNA can be regarded as a hopeful diagnostic instrument in RCC. Larger multicenter sample studies are required to validate our conclusions further externally and to make this method more sensitive and specific.