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Purpose: Studies have reported that breast cancer (BC) patients' circulating tumor cells (CTCs) have varying results for their diagnostic role. Thus, we conducted a meta-analysis to systematically assess the accuracy of CTCs in the diagnosis of BC. Methods: A meta-analysis was conducted to evaluate the overall accuracy of CTC detection. A pooled analysis of sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic advantage ratio (DOR) was used to measure diagnostic accuracy. In addition, the area under the summary receiver operating characteristic curve (AUC) was used to discriminate BC from non-BC. An analysis of the threshold effect was calculated using the Spearman correlation coefficient. We calculated the Q and I2 statistics to determine whether the studies were heterogeneous. Sensitivity analysis was performed by removing studies one by one. Publication bias was assessed by Deeks' funnel plot asymmetry test. Results: Studies from the PubMed, Cochrane Library, Embase, Web of Science, Wanfang, Vip, and CNKI databases were collected for diagnosing BC from January 2000 to April March 2023. Finally, 8 publications were retrieved in total containing 2014 cases involved in the study. Based on a random-effects model, it was found that the pooled SEN was 0.69 (0.55 - 0.80), SPE was 0.93 (0.60 - 0.99), PLR was 9.5 (1.4 - 65.9), NLR was 0.33 (0.23 - 0.48), DOR was 29 (4 - 205) and the AUC of the summary receiver operating characteristic (SROC) curve was 0.81 (0.77 - 0.84). Some heterogeneity was found in the article, but there was no threshold effect to account for it (P = 0.27). Deek's funnel plot asymmetry test indicated that no publication bias was observed in this meta-analysis (P = 0.52). Conclusion: The results of this meta-analysis confirmed that CTCs were an important component of noninvasive methods of confirming BC with SEN of 0.69 (0.55 - 0.80), SPE of 0.93 (0.60 - 0.99) and AUC of 0.81 (0.77 - 0.84).
RESUMO
OBJECTIVE: To explore the brain effect mechanism and the correlation between brain functional imaging and cognitive function in treatment of depressive disorder (DD) with transcutaneous auricular vagus nerve stimulation (taVNS) based on the resting-state functional magenetic reasonance imaging (rs-fMRI). METHODS: Thirty-two DD patients were included in a depression group and 32 subjects of healthy condition were enrolled in a normal group. In the depression group, the taVNS was applied to bilateral Xin (CO15) and Shen (CO10), at disperse-dense wave, 4 Hz/20 Hz in frequency and current intensity ≤20 mA depending on patient's tolerance, 30 min each time, twice daily. The duration of treatment consisted of 8 weeks. The patients of two groups were undertaken rs-fMRI scanning. The scores of Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) and Wisconsin card sorting test (WCST) were observed in the normal group at baseline and the depression group before and after treatment separately. The differential brain regions were observed before and after treatment in the two groups and the value of degree centrality (DC) of fMRI was obtained. Their correlation was analyzed in terms of HAMD, HAMA and WCST scores. RESULTS: The scores of HAMD and HAMA in the depression group were all higher than those in the normal group (P<0.05). After treatment, the scores of HAMD and HAMA were lower than those before treatment in the depression group; the scores of total responses, response errors and perseverative errors of WCST were all lower than those before treatment (P<0.05). The brain regions with significant differences included the left inferior temporal gyrus, the left cerebellar peduncles region 1, the left insula, the right putamen, the bilateral supplementary motor area and the right middle frontal gyrus. After treatment, the value of DC in left supplementary motor area was negatively correlated to HAMD and HAMA scores respectively (r=-0.324, P=0.012; r=-0.310, P=0.015); the value of DC in left cerebellar peduncles region 1 was negatively correlated to the total responses of WCST (r=-0.322, P=0.013), and the left insula was positively correlated to the total responses of WCST (r=0.271, P=0.036). CONCLUSION: The taVNS can modulate the intensity of the functional activities of some brain regions so as to relieve depressive symptoms and improve cognitive function.