Meta-Analysis
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World J Gastroenterol. Oct 14, 2014; 20(38): 14040-14050
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.14040
Accuracy of early detection of colorectal tumours by stool methylation markers: A meta-analysis
Hu Zhang, Jian Qi, Ya-Qiong Wu, Ping Zhang, Jun Jiang, Qi-Xian Wang, You-Qing Zhu
Hu Zhang, Jian Qi, Qi-Xian Wang, You-Qing Zhu, Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
Ya-Qiong Wu, Department of Dermatology, Yijishan Hospital of Wannan Medical College, Wuhu 241001, Anhui Province, China
Hu Zhang, Ping Zhang, Jun Jiang, Department of Gastroenterology, Hubei Provincial Corps Hospital, Chinese People’s Armed Police Force, Wuhan 430061, Hubei Province, China
Author contributions: Zhu YQ and Qi J designed this study and critically revised the article; Zhang H and Qi J were responsible for data acquisition and extracting the data; Zhang H drafted the manuscript, analysed the data and interpreted the results; Wu YQ, Zhang P, Jiang J and Wang QX were involved in editing the manuscript; all authors read and approved the final manuscript to be published.
Correspondence to: Jian Qi, PhD, Department of Gastroenterology and Clinical Centre of Intestinal and Colorectal Diseases of Hubei Province, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China. qiqidelizi@aliyun.com
Telephone: +86-27-87336141 Fax: +86-27-87336141
Received: January 24, 2014
Revised: April 24, 2014
Accepted: June 26, 2014
Published online: October 14, 2014
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 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 37 articles, and the pooled results showed that stool methylation markers could be used as a valuable diagnostic and predictive tool for colorectal tumours, and that SFRP2 methylation serves as a promising marker with great potential in early colorectal cancer diagnosis.