Accuracy of Raman spectroscopy in discrimination of nasopharyngeal carcinoma from normal samples: a systematic review and meta-analysis Abstract Objectives The aim of this review was to systematically evaluate the diagnostic accuracy of Raman spectroscopy (RS) in the identification of nasopharyngeal carcinomas from normal nasopharyngeal tissue. Methods We searched six databases (PubMed, Embase, Cochrane Library, Web of Science, Scopus and CNKI) up to September 2018 for all published studies that assessed the diagnostic accuracy of RS in the detection of nasopharyngeal carcinomas. Non-qualifying studies were screened out in accordance with the specified exclusion criteria and relevant information about the diagnostic performance of RS extracted. A random effects model was adopted to calculate the pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic threshold and diagnostic odds ratio (DOR). Additionally, we conducted a summary receiver-operating characteristic (SROC) curve analysis and threshold analysis, reporting area under the curve (AUC) to evaluate the overall performance of RS. Results Three studies examined RS analysis in vivo, the pooled sensitivity and specificity of RS of which were 0.90 and 0.91, respectively, with an AUC of 0.9617. Eighteen studies assessed ex vivo samples, for which RS exhibited particularly high accuracy for the analysis of blood plasma. Conclusions RS was demonstrated to be a reliable technique for the detection of nasopharyngeal carcinoma with high accuracy, but additional studies are required to improve its performance and expand its application in ex vivo detection.