高复发风险黑色素瘤疾病进展监测中ctDNA、LDH与S100阳性率的Meta分析比较OA

Objective To comprehensively compare the positivity rates of three serological markers—circulating tumor DNA(ctDNA),lactate dehydrogenase(LDH),and S100 protein—in monitoring disease progression in high-recurrence-risk melanoma,and to clarify differences in their detection performance,thereby providing evidence-based guidance for clinical practice and research.Methods A systematic search was conducted in multiple Chinese and English databases for literature published between 2015 and 2025.Prospective or retrospective observational studies reporting elevated levels of the above markers at disease progression in stage ⅡB/ⅡC/Ⅲ/Ⅳ melanoma patients were selected.Study quality was assessed using the Joanna Briggs Institute(JBI)critical appraisal tool for case series.A random-effects model was applied for single-group rate Meta-analysis and pairwise comparisons between markers.Results Eleven high-quality studies involving 1,306 patients were included.Meta-analysis showed that ctDNA had the highest pooled positivity rate(68%,95%CI:0.61-0.74)with no heterogeneity across studies(I2=0).The pooled positivity rate for LDH was 50.2%(95%CI:0.444-0.559),also without heterogeneity(I2=0).S100 had the lowest pooled positivity rate(38%)but exhibited high heterogeneity(I2=85.9%).Pairwise comparisons indicated that the positivity rate of ctDNA was significantly higher than those of LDH and S100,and LDH was significantly higher than S100.Heterogeneity for S100 was mainly attributed to differences in disease stage and country.Conclusions In monitoring disease progression in high-recurrence-risk melanoma,ctDNA may be prioritized as a serological marker with high sensitivity and stability to assist in evaluating tumor burden and treatment response.