Meta-Analysis
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World J Meta-Anal. Nov 26, 2013; 1(3): 147-156
Published online Nov 26, 2013. doi: 10.13105/wjma.v1.i3.147
Accuracy of early detection of colorectal tumours using stool methylation markers: A meta-analysis
Hu Zhang, You-Qing Zhu, Jian Qi, Qi-Xian Wang, Sha-Sha Cai, Si-Ying Zhu, Xiao-Wen Zhu, Xin-Tao Wang
Hu Zhang, You-Qing Zhu, Jian Qi, Qi-Xian Wang, Sha-Sha Cai, Si-Ying Zhu, Xiao-Wen Zhu, Xin-Tao Wang, Department of Gastroenterology and Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
Author contributions: Qi J and Zhu YQ designed this study and critically revised the article; Zhang H and Qi J were responsible for data acquisition and extracted the data; Zhang H drafted the manuscript, analyzed the data and interpreted the results; Wang QX, Cai SS, Zhu SY, Zhu XW and Wang XT were involved in editing the manuscript; all authors read and approved the final manuscript to be published.
Supported by The National Natural Science Foundation of China Youth Science Fund, No. 81101868; The Natural Science Foundation of Hubei Province of China, No. 2011CDB505
Correspondence to: Dr. Jian Qi, Department of Gastroenterology and Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, 169 Wuchang Donghu Lu, Wuhan 430071, Hubei Province, China. qiqidelizi@aliyun.com
Telephone: +86-27-87336141 Fax: +86-27-87336141
Received: July 9, 2013
Revised: October 21, 2013
Accepted: November 2, 2013
Published online: November 26, 2013
Processing time: 162 Days and 22.4 Hours
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 Journal Full Text Database and Wanfang Journals Full-text Database were searched to find relevant original articles about methylated genes used in diagnosing colorectal tumours. Quality assessment of diagnostic accuracy studies items were 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-four articles met the inclusion criteria, and 4151 patients were included. Pooled diagnostic performances of SFRP2 methylation for colorectal cancer (CRC) provided the following results: the sensitivity was 79% (95%CI: 75%-82%), the specificity was 93% (95%CI: 90%-96%), the diagnostic odds ratio (DOR) was 47.57 (95%CI: 20.08-112.72), and the area under the curve was 0.9565. Additionally, the results of accuracy of SFRP2 methylation for detecting colorectal adenomas were as follows: the sensitivity was 43% (95%CI: 38%-49%), the specificity was 94% (95%CI: 91%-97%), the DOR 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 non-invasively diagnosing colorectal tumours, and SFRP2 methylation is a promising marker that has great potential in early CRC diagnosis.

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

Core tip: The analysis of stool methylation markers as a non-invasive test is important for the early diagnosis of colorectal tumours. However, no consensus has been reached with regard to the role of stool methylation markers in colorectal tumour diagnosis. We performed a meta-analysis of 34 articles, and the pooled results showed that stool methylation markers could be used as a valuable diagnostic and predictive tool for colorectal tumours and SFRP2 methylation serves as a promising marker with great potential in early colorectal cancer diagnosis.