Association between Ras association domain family 1A promoter methylation and hepatocellular carcinoma: A meta-analysis

AIM: To assess diagnostic accuracy of Ras association domain family 1A (RASSF1A) promoter methylation in body fluids (serum, plasma and whole blood) for hepatocellular carcinoma (HCC). METHODS: Relative information about study characteristics and incidence of RASSF1A methylation was collected. Quality of all included studies was evaluated by Quality Assessment of Diagnostic Accuracy Studies-2. Sensitivity and specificity were pooled using a random-effect model, and a summary receiver operating characteristic curve was used to demonstrate the overall diagnostic performance. Positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) with 95%CI were also calculated. Meta-regression was applied to analyze observed heterogeneity, and Deeks' test was performed to detect publication bias. RESULTS: After a systematic literature review, seven studies with a total of 302 cases of HCC and 250 cases of chronic liver diseases were included in the analysis. The pooled sensitivity and specificity were 0.70 (95% CI: 0.49-0.85) and 0.72 (95% CI: 0.54-0.85), respectively. The PLR was 2.51 (95% CI: 1.64-3.86), NLR was 0.41 (95% CI: 0.25-0.68), and DOR was 6.13 (95% CI: 3.17-11.84). The chi(2) values of sensitivity, specificity, PLR, NLR and DOR were 59.41 (P<0.001), 50.50 (P<0.001), 17.40 (P=0.010), 31.24 (P<0.001) and 80.51 (P<0.001), respectively. The area under the curve was 0.77 (95% CI: 0.73-0.81). Three factors were analyzed by univariate meta-regression and none was significant to interpret the observed heterogeneity (P>0.05). No significant publication bias was detected by Deeks' test (P=0.346). CONCLUSION: We showed the potential diagnostic value of RASSF1A methylation in body fluids in HCC patients and it may improve diagnostic accuracy combined with the a-fetoprotein test. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.