{"doi":"10.1371/journal.pone.0299447","title":"Meta-analysis of the accuracy for RASSF1A methylation in bronchial aspirates for the diagnosis of lung cancer","abstract":"OBJECTIVE: To establish the diagnostic accuracy of RASSF1A (Ras association domain family 1 isoform) methylation using bronchial aspirates as an auxiliary method for diagnosing lung cancer through a systematic review and meta-analysis. METHODS: Studies published prior to October 30, 2022, were retrieved from the Embase, PubMed, Web of Science, and Wan Fang databases using the keywords \"lung cancer\", \"RASSF1A\", \"methylation\", and \"bronchial aspirates\". A fixed or random effect model was used to calculate the combined sensitivity, specificity, positive likelihood ratios (LR), negative LR, diagnostic odds ratio (DOR), along with the respective 95% confidence intervals (CIs) and the area under the curve (AUC) with Q index. The threshold effect was defined by using the Spearman correlation coefficient, and the Deeks funnel plot was generated to evaluate publication bias. RESULTS: Among the 12 trials that met the inclusion criteria, a total of 2388 participants were involved. The pooled results for the diagnosis of lung cancer were as follows, when compared to the pathological diagnosis: sensitivity of 0.47 (95% CI: 0.45-0.50), specificity of 0.96 (95% CI: 0.95-0.97), positive LR of 12.18 (95% CI: 8.96-16.55), negative LR of 0.56 (95% CI: 0.52-0.61), DOR of 24.05 (95% CI: 17.29-33.47), and AUC of 0.78 (Q index = 0.72), respectively. The sensitivity of the RASSF1A methylation assay was relatively low in a detailed subgroup analysis, fluctuating between 0.39 and 0.90, indicating a limitation in its diagnostic value for lung cancer. The RASSF1A methylation assay, on the other hand, demonstrated excellent specificity, suggesting a high exclusion value. Of note, the diagnostic sensitivity, specificity, DOR, and AUC for small cell lung cancer were 0.90 (0.84-0.94), 0.95 (0.94-0.97), 249.5 (103.94-598.8), and 0.98, respectively, showing that RASSF1A methylation was a promising biomarker for diagnosing small cell lung cancer with both high diagnostic and exclusion value. Furthermore, RASSF1A methylation using bronchial washings and bronchial aspirates showed a high AUC of 0.998 and 0.93, respectively, indicating excellent diagnostic performance. CONCLUSIONS: The methylation of RASSF1A in bronchial aspirates demonstrated a high level of diagnostic accuracy and has the potential to be a valuable supplementary diagnostic method, especially for identifying small cell lung cancer.","journal":"PLoS ONE","year":2024,"id":461191,"datarank":0.21897149567689184,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.01102734150890822,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.01102734150890822,"corpus_percentile":37.216678270287,"corpus_rank":8117,"citation_count":3,"citer_count":3,"citers_with_citation_signal":2,"citers_with_endowment":2,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.56,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1290169,"name":"Shi-xu He","orcid":null,"position":1,"is_corresponding":false},{"id":1289705,"name":"M Chen","orcid":"0000-0002-9663-7414","position":2,"is_corresponding":false},{"id":1289706,"name":"Fubin Chen","orcid":"0000-0002-8091-1933","position":3,"is_corresponding":false},{"id":1289707,"name":"Peng Wu","orcid":"0009-0003-6409-435X","position":4,"is_corresponding":false},{"id":1289708,"name":"Ping Shi","orcid":"0000-0002-7950-031X","position":5,"is_corresponding":false},{"id":1290170,"name":"Shi-cai Zhao","orcid":null,"position":6,"is_corresponding":false},{"id":1289709,"name":"Lingyan Zhao","orcid":"0000-0003-2648-2426","position":7,"is_corresponding":false},{"id":1290171,"name":"Xiaomin Xiong","orcid":null,"position":8,"is_corresponding":false},{"id":1289710,"name":"Jia Zeng","orcid":"0000-0002-9372-0685","position":9,"is_corresponding":false},{"id":1290168,"name":"Xu-ping Chen","orcid":null,"position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T02:04:12.271488Z","pmid":"39052646","pmcid":"PMC11271935","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}