{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:47:06Z","timestamp":1793396826526,"version":"4.5.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009564","name":"Health and Family Planning Commission of Sichuan Province","doi-asserted-by":"publisher","award":["S20030"],"award-info":[{"award-number":["S20030"]}],"id":[{"id":"10.13039\/501100009564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To establish the diagnostic accuracy of <jats:italic>RASSF1A<\/jats:italic> (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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Studies published prior to October 30, 2022, were retrieved from the Embase, PubMed, Web of Science, and Wan Fang databases using the keywords \u201clung cancer\u201d, \u201c<jats:italic>RASSF1A<\/jats:italic>\u201d, \u201cmethylation\u201d, and \u201cbronchial aspirates\u201d. 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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>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\u20130.50), specificity of 0.96 (95% CI: 0.95\u20130.97), positive LR of 12.18 (95% CI: 8.96\u201316.55), negative LR of 0.56 (95% CI: 0.52\u20130.61), DOR of 24.05 (95% CI: 17.29\u201333.47), and AUC of 0.78 (Q index = 0.72), respectively. The sensitivity of the <jats:italic>RASSF1A<\/jats:italic> 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 <jats:italic>RASSF1A<\/jats:italic> 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\u20130.94), 0.95 (0.94\u20130.97), 249.5 (103.94\u2013598.8), and 0.98, respectively, showing that <jats:italic>RASSF1A<\/jats:italic> methylation was a promising biomarker for diagnosing small cell lung cancer with both high diagnostic and exclusion value. Furthermore, <jats:italic>RASSF1A<\/jats:italic> methylation using bronchial washings and bronchial aspirates showed a high AUC of 0.998 and 0.93, respectively, indicating excellent diagnostic performance.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The methylation of <jats:italic>RASSF1A<\/jats:italic> 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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0299447","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T17:39:03Z","timestamp":1721929143000},"page":"e0299447","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Meta-analysis of the accuracy for RASSF1A methylation in bronchial aspirates for the diagnosis of lung 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