Moreover, metastases occur in 4.2–7.1% of RCa patients when the diameter of the tumor is <4 cm, and this relates to an 8% 5-years survival rate for these patients ( Lughezzani et al., 2009). Although developments in computed tomography and magnetic resonance imaging have increased the proportion of diagnoses for the early stages of RCa, only 47% of RCa patients with locoregional disease can survive more than 5 years ( Choueiri and Motzer, 2017).
More than 73,000 new cases of RCa are diagnosed in the United States every year, with 330,000 new cases globally ( Capitanio et al., 2019 Siegel et al., 2019). Renal cancer (RCa) is the 13th most common cancer in the world and accounts for 2.4% of all cancers the highest incidence of RCa has been reported in developed countries ( Capitanio et al., 2019). Therefore, cf-DNA is a useful biomarker for the diagnosis of RCa. Collectively, our data demonstrate that cf-DNA has high specificity and sensitivity for diagnosing RCa. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79–0.85), and the diagnostic odds ratio was 7.80 (95% CI, 4.40–13.85). The pooled positive likelihood ratio and pooled negative likelihood ratio were 3.42 (95% CI, 2.04–5.72) and 0.36 (95% CI, 0.23–0.58), respectively. The overall diagnostic sensitivity and specificity for cf-DNA was 0.71 (95% confidence interval (CI), 0.55–0.83) and 0.79 (95% CI, 0.66–0.88), respectively. In total, 8 studies, featuring 754 RCa patients, and 355 healthy controls, met our inclusion criteria. For all patients, we evaluated the true diagnostic value of cf-DNA by calculating the number of true positive, false positive, true negative, and false negative, diagnoses by extracting specificity and sensitivity data from the selected literature. Systematic searches were conducted using Pubmed, Embase databases, Web of Science, Medline and Cochrane Library to identify relevant publications until the 31st March 2021. We performed a meta-analysis of published data to investigate the diagnostic value of cf-DNA for renal cancer (RCa). 9Experimental Research Center, Zhejiang Cancer Hospital, Institute of Cancer Research and Basic Medicine, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, ChinaĬell-free DNA (cf-DNA) has been reported to represent a suitable material for liquid biopsy in the diagnosis and prognosis of various cancers.8Department of Urology, North Hospital, University of Jean-Monnet, Saint-Etienne, France.7Comprehensive Cancer Center, Charité Universitätsmedizin, Berlin, Germany.6Translational Radiation Oncology Research Laboratory, Department of Radiooncology and Radiotherapy, Charite University Hospital, Berlin, Germany.5Central Research Laboratory, Children’s Hospital of Nanchang University, Hangzhou, China.4Department of Ultrasound, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China.3The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.2Hangzhou Traditional Chinese Medicine Hospital, Zhejiang Chinese Medical University, Hangzhou, China.1Department of Urology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzho, China.Yipeng Xu 1 †, Yingjun Jiang 2 †, Mingke Yu 3 †, Jianmin Lou 3, Mei Song 4, Han Xu 5, Yingying Cui 6, Xiaowei Zeng 1,2, Qibo Wang 1, Hanyun Ma 7, Zongping Wang 1, Shaoxing Zhu 1 *, Guorong Li 8 and An Zhao 9*
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