Zhou Xuan-Jun, Dong Zhao-Gang, Yang Yong-Mei, Du Lu-Tao, Zhang Xin, Wang Chuan-Xin
Department of Clinical Laboratory, Qilu Hospital, Shandong University, Jinan, China E-mail :
Asian Pac J Cancer Prev. 2013;14(8):4699-704. doi: 10.7314/apjcp.2013.14.8.4699.
MicroRNAs have been demonstrated to play important roles in the development and progression of colorectal cancer. Several studies utilizing microRNAs as diagnostic biomarkers for colorectal cancer (CRC) have been reported. The aim of this meta-analysis was to comprehensively and quantitatively summarize the diagnostic value of microRNAs for detecting colorectal cancer.
We searched PubMed, Embase and Cochrane Library for published studies that used microRNAs as biomarkers for the diagnosis of colorectal cancer. Summary estimates for sensitivity, specificity and other measures of accuracy of microRNAs in the diagnosis of colorectal cancer were calculated using the bivariate random effects model. A summary receiver operating characteristic (SROC) curve was also generated to summarize the overall effectiveness of the test.
Thirteen studies from twelve published articles met the inclusion criteria and were included. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odd ratio of microRNAs for the diagnosis of colorectal cancer were 0.81 (95%CI: 0.79-0.84), 0.78 (95%CI: 0.75-0.82), 4.14 (95%CI: 2.90- 5.92), 0.24 (95%CI: 0.19-0.30), and 19.2 (95%CI: 11.7-31.5), respectively. The area under the SROC curve was 0.89.
The current evidence suggests that the microRNAs test might not be used alone as a screening tool for CRC. Combining microRNAs testing with other conventional tests such as FOBT may improve the diagnostic accuracy for detecting CRC.
微小RNA已被证明在结直肠癌的发生和发展中起重要作用。已有多项利用微小RNA作为结直肠癌诊断生物标志物的研究报道。本荟萃分析的目的是全面、定量地总结微小RNA在检测结直肠癌方面的诊断价值。
我们在PubMed、Embase和Cochrane图书馆中检索已发表的使用微小RNA作为结直肠癌诊断生物标志物的研究。使用双变量随机效应模型计算微小RNA诊断结直肠癌的敏感性、特异性和其他准确性指标的汇总估计值。还生成了汇总受试者工作特征(SROC)曲线以总结该检测的总体有效性。
来自12篇已发表文章的13项研究符合纳入标准并被纳入。微小RNA诊断结直肠癌的总体敏感性、特异性、阳性似然比、阴性似然比和诊断比值比分别为0.81(95%CI:0.79 - 0.84)、0.78(95%CI:0.75 - 0.82)、4.14(95%CI:2.90 - 5.92)、0.24(95%CI:0.19 - 0.30)和19.2(95%CI:11.7 - 31.5)。SROC曲线下面积为0.89。
目前的证据表明,微小RNA检测可能不能单独用作结直肠癌的筛查工具。将微小RNA检测与其他传统检测方法(如粪便潜血试验)相结合可能会提高结直肠癌检测的诊断准确性。