Meta-analytic and systematic review of the diagnostic value of DNA methylation-based biomarkers in cervical cancer.

IntroductionCervical cancer represents a significant global health problem, ranking as the fourth most prevalent malignant cancer in women, particularly in low- and middle-income countries. Epigenetic silencing via aberrant methylation of tumor suppressor genes' promoters represent a second hit of cancer initializing, as well as progressing. The aim of current meta-analysis was to systematically evaluate the potential of DNA methylation-based biomarkers in non-invasive or minimal invasive samples using molecular-based approaches for cervical cancer screening and diagnosis.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was applied to perform our meta-analysis. The frequency, odds ratios, sensitivity as well as specificity with the corresponding 95% confidence intervals were used to assess the effect sizes.ResultsThere were 20 eligible articles ultimately included in the current meta-analysis. In this meta-analysis, multiple tumor suppressor genes, such as, especially, PAX1, SOX1, CDO1, GHSR, were shown to undergo hypermethylation in cervical cancer samples compared with controls. Urine samples, when combined with MSP- and qMSP-based approaches, emerged as a particularly effective non-invasive strategy.ConclusionThe current meta-analysis highlighted the important steps toward establishing DNA-methylation-based biomarkers as accessible and reliable tools for CC screening and diagnosis.