Jiang Jian-Xin, Zhang Na, Liu Zhong-Min, Wang Yan-Ying
Research Center for Translational Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China E-mail :
Asian Pac J Cancer Prev. 2014;15(18):7583-8. doi: 10.7314/apjcp.2014.15.18.7583.
Colorectal cancer (CRC) is a major cause of cancer-related death and cancer-related incidence worldwide. The potential of microRNA-21 (miR-21) as a biomarker for CRC detection has been studied in several studies. However, the results were inconsistent. Therefore, we conducted the present meta-analysis to systematically assess the diagnostic value of miR-21 for CRC.
Using a random-effect model, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated to evaluate the diagnostic performance of miR-21 for CRC. A summary receiver operating characteristic (SROC) curve and an area under the curve (AUC) were also generated to assess the diagnosis accuracy of miR-21 for CRC. Q test and I2 statistics were used to assess between- study heterogeneity. Publication bias was evaluated by the Deeks' funnel plot asymmetry test.
A total of 986 CRC patients and 702 matched healthy controls from 8 studies were involved in the meta-analysis. The pooled results for SEN, SPE, PLR, NLR, DOR, and AUC were 57% (95%CI: 39%-74%), 87% (95%CI: 78%- 93%), 4.4 (95%CI: 2.4-8.0), 0.49 (95%CI: 0.32-0.74), 9 (95%CI: 4-22), and 0.83 (95%CI: 0.79-0.86), respectively. Subgroup analyses further suggested that blood-based studies showed a better diagnostic accuracy compared with feces-based studies, indicating that blood may be a better matrix for miR-21 assay and CRC detection.
Our findings suggest that miR-21 has a potential diagnostic value for CRC with a moderate level of overall diagnostic accuracy. Hence, it could be used as auxiliary means for the initial screening of CRC and avoid unnecessary colonoscopy, which is an invasive and expensive procedure.
结直肠癌(CRC)是全球癌症相关死亡和癌症相关发病率的主要原因。多项研究探讨了微小RNA-21(miR-21)作为CRC检测生物标志物的潜力。然而,结果并不一致。因此,我们进行了本荟萃分析,以系统评估miR-21对CRC的诊断价值。
采用随机效应模型,计算合并敏感度(SEN)、特异度(SPE)、阳性似然比(PLR)、阴性似然比(NLR)和诊断比值比(DOR),以评估miR-21对CRC的诊断性能。还生成了汇总受试者工作特征(SROC)曲线和曲线下面积(AUC),以评估miR-21对CRC的诊断准确性。采用Q检验和I²统计量评估研究间异质性。通过Deeks漏斗图不对称性检验评估发表偏倚。
本荟萃分析共纳入8项研究中的986例CRC患者和702例匹配的健康对照。SEN、SPE、PLR、NLR、DOR和AUC的合并结果分别为57%(95%CI:39%-74%)、87%(95%CI:78%-93%)、4.4(95%CI:2.4-8.0)、0.49(95%CI:0.32-0.74)、9(95%CI:4-22)和0.83(95%CI:0.79-0.86)。亚组分析进一步表明,与基于粪便的研究相比,基于血液的研究显示出更好的诊断准确性,这表明血液可能是miR-21检测和CRC检测的更好基质。
我们的研究结果表明,miR-21对CRC具有潜在的诊断价值,总体诊断准确性处于中等水平。因此,它可作为CRC初步筛查的辅助手段,避免不必要的结肠镜检查,因为结肠镜检查是一种侵入性且昂贵的检查。