微小RNA-21在结直肠癌中的诊断和预后价值：一项原始研究及个体参与者数据的荟萃分析
Diagnostic and prognostic value of microRNA-21 in colorectal cancer: an original study and individual participant data meta-analysis.
作者信息
Zhang Honghe, Li Peiwei, Ju Haixing, Pesta Martin, Kulda Vlastimil, Jin Wenjun, Cai Mao, Liu Changbao, Wu Han, Xu Jinming, Ye Yao, Zhang Guanglin, Xu Enping, Cai Jianting, Lai Maode, Xia Dajing, Yang Jun, Wu Yihua
机构信息
Zhejiang University School of Medicine, Hangzhou, China. Department of Pathology, Zhejiang University School of Medicine, Hangzhou, China.
Zhejiang University School of Medicine, Hangzhou, China. Department of Gastroenterology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China.
出版信息
Cancer Epidemiol Biomarkers Prev. 2014 Dec;23(12):2783-92. doi: 10.1158/1055-9965.EPI-14-0598. Epub 2014 Sep 1.
BACKGROUND
We aimed to systematically summarize the diagnostic and prognostic value of circulating/tissue miR21 in patients with colorectal cancer.
METHODS
An original study was conducted to explore the potential value of circulating miR21 in colorectal cancer diagnosis and tissue miR21 in colorectal cancer prognosis. PUBMED and EMBASE were searched (to August, 2013) to identify eligible studies. To explore the diagnostic performance of circulating miR21, meta-analysis methods were used to pool sensitivity, specificity, positive and negative likelihood ratio, diagnostic OR and to construct a summary ROC curve. For prognostic meta-analysis, study-specific HRs of tissue miR21 for survival were summarized. Subgroup and sensitivity analyses were applied to explore heterogeneity.
RESULTS
Finally, 14 studies (including our study) were included in the meta-analyses. The pooled sensitivity, specificity, and AUC of circulating miR21 were 0.76 [95% confidence interval (CI), 0.59-0.88], 0.81 (95% CI, 0.76-0.85), and 0.81 (95% CI, 0.78-0.85) in diagnosing colorectal cancer. Patients with higher expression of tissue miR21 had significant inferior overall survival (OS; pooled HR, 1.56; 95% CI, 1.16-2.11) and disease-free survival (DFS; pooled HR, 1.35; 95% CI, 1.08-1.69). The individual participant data (IPD) meta-analysis demonstrated that tissue miR21 level was independently associated with worse colorectal cancer OS (HR, 1.69; 95% CI, 1.07-2.67; P = 0.023), whereas this association seems to be confined to males (P = 0.007) but not for females (P = 0.845).
CONCLUSIONS
Circulating miR21 level has potential value for colorectal cancer early detection, whereas high tissue miR21 level is associated with adverse colorectal cancer prognosis.
IMPACT
miR21 is a promising biomarker for early detection and prognosis of colorectal cancer. Cancer Epidemiol Biomarkers Prev; 23(12); 2783-92. ©2014 AACR.
背景
我们旨在系统总结循环/组织miR21在结直肠癌患者中的诊断和预后价值。
方法
开展一项原始研究以探索循环miR21在结直肠癌诊断中的潜在价值以及组织miR21在结直肠癌预后中的潜在价值。检索了PUBMED和EMBASE（截至2013年8月）以确定符合条件的研究。为探索循环miR21的诊断性能，采用荟萃分析方法汇总敏感性、特异性、阳性和阴性似然比、诊断比值比并构建汇总ROC曲线。对于预后荟萃分析，汇总了组织miR21对生存的研究特异性风险比。应用亚组分析和敏感性分析来探索异质性。
结果
最终，14项研究（包括我们的研究）纳入了荟萃分析。循环miR21在诊断结直肠癌时的汇总敏感性、特异性和AUC分别为0.76 [95%置信区间（CI），0.59 - 0.88]、0.81（95% CI，0.76 - 0.85）和0.81（95% CI，0.78 - 从0.85）。组织miR21表达较高的患者总生存期（OS；汇总风险比，1.56；95% CI，1.16 - 2.11）和无病生存期（DFS；汇总风险比，1.35；95% CI，1.08 - 1.69）显著较差。个体参与者数据（IPD）荟萃分析表明，组织miR21水平与较差的结直肠癌OS独立相关（风险比，1.69；95% CI，1.07 - 2.67；P = 0.023），而这种关联似乎仅限于男性（P = 0.007），对女性则不然（P = 0.845）。
结论
循环miR21水平对结直肠癌早期检测具有潜在价值，而组织miR21水平高与结直肠癌不良预后相关。
影响
miR21是结直肠癌早期检测和预后的一个有前景的生物标志物。癌症流行病学、生物标志物与预防；23(12)；2783 - 2792。©2014美国癌症研究协会。
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