Peptide Nucleic Acid Clamping and Direct Sequencing in the Detection of Oncogenic Alterations in Lung Cancer: Systematic Review and Meta-Analysis
Yonsei Medical Journal 2018³â 59±Ç 2È£ p.211 ~ p.218
¼ÛÀç¿í(Song Jae-Uk) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
ÀÌÁ¾ÈÄ(Lee Jong-Hoo) - Jeju National University School of Medicine Jeju National University Hospital Department of Internal Medicine
Abstract
Purpose: Molecular testing in non-small cell lung cancer (NSCLC) aids in identifying oncogenic alterations. The aim of this study was to compare the rates of detection of oncogenic alterations and responsiveness to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) according to EGFR mutation status as determined by peptide nucleic acid (PNA) clamping or direct sequencing (DS).
Materials and Methods: We performed a systematic literature search using MEDLINE, EMBASE, and the Cochrane Central Register. Data from included studies were pooled to yield summary sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and receiver operating characteristic curves. A meta-regression analysis was conducted to identify potential sources of heterogeneity between selected studies.
Results: We identified 10 studies comprising 924 patients. Oncogenic alterations were detected in 340 of 924 cases (36.8%) with PNA clamping and in 250 of 924 (27.1%) with DS. The pooled sensitivities of PNA clamping and DS were 0.93 [95% confidence interval (CI): 0.90?0.95] and 0.69 (95% CI: 0.64?0.73), respectively. According to meta-regression analysis, none of the covariates were found to be significant sources of heterogeneity. With respect to treatment responses to EGFR-TKIs, there was no significant difference therein between EGFR mutations detected by PNA clamping and DS (53.4% vs. 50.8%; risk ratio, 0.99; 95% CI 0.83?1.19; p=0.874).
Conclusion: We demonstrated that PNA clamping has a higher sensitivity than DS for detecting oncogenic alterations in NSCLC. Our findings suggest that PNA clamping is a more useful method for clinical practice.
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Genetic testing, peptide nucleic acids, epidermal growth factor, lung neoplasms
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ºñ¼Ò¼¼Æ÷Æó¾ÏÀÇ ¹ß¾Ï¼ºº¯È´Â Àüü 924¸íÀÇ Áø´Ü¹ÞÀº Æó¾ÏȯÀÚ(NSCLC) Áß¿¡ 340¸í(36.8%)°¡ PNA Clamping¿¡ ÀÇÇØ ±¸º°µÇ¾ú°í, DS¿¡ ÀÇÇØ Áø´Ü¹ÞÀº ȯÀÚ´Â ÀüüÀÇ 250¸í(27.1%)·Î ³ªÅ¸³µ´Ù. ¹Î°¨µµ¿ª½Ã PNA Clamping°ú DS°¡ °¢°¢ 0.93 [95% confidence interval (CI): 0.90-0.95] and 0.69 (95% CI: 0.64-0.73)·Î º¸°íµÇ¾ú´Ù.