Diagnostic accuracy of circulating-free DNA for the determination of hepatocellular carcinoma: a systematic review and meta-analysis.

ABSTRACT

INTRODUCTION: Circulating cell-free DNA (cfDNA) is a good diagnostic tool for hepatocellular carcinoma as it can comprehensively reflect the heterogeneity of tumors and aid in their early detection. This study aimed to assess the diagnostic value of circulating cfDNA for hepatocellular carcinoma. METHODS: PubMed, EMBASE, Web of Science, Cochrane Library, and Scopus databases were searched to identify all relevant literature from their dates of establishment to 6 April 2022, and a total of 2,467 articles were found. Methodological quality assessment was performed using QUADAS-2. RESULTS: Fifteen articles with 3,686 patients were included in this study after screening. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve were 0.83 (95% confidence interval [CI] 0.78, 0.87), 0.90 (95% CI 0.86, 0.93), 8.4 (95% CI 5.9, 12.0), 0.19 (95% CI 0.15, 0.24), 44 (95% CI 30, 66), and 0.93 (95% CI 0.90, 0.95), respectively. Deek's funnel plot test did not show significant publication bias (P = 0.28). CONCLUSIONS: Results of this meta-analysis suggest that circulating cfDNA has moderate sensitivity and excellent specificity for the detection of hepatocellular carcinoma as a noninvasive test (0.83 and 0.90, respectively).