Han Chunshan, Yu Haixiang, Zhang Lening, Li Xiaoli, Feng Yonggang, Xin Hua
Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, 130033, Jilin, China.
Tumour Biol. 2015 Mar;36(3):1755-62. doi: 10.1007/s13277-014-2777-0. Epub 2014 Oct 31.
The low survival rates of cancers are primarily due to late diagnosis and metastasis. Discriminating the metastasis is a crucial factor for prognosis and improving the survival rate of cancer patients. MicroRNAs (miRNAs) can regulate the expression of hundreds of downstream genes, which has a broad effect on the regulation of the whole cell cycle. Accumulating studies have found that the aberrant expression of miRNAs is associated with cancer genesis. The aim of this study is to evaluate the diagnostic value of miRNAs in detecting cancer metastasis. Medline, PubMed, Embase, and CNKI were searched for relevant articles. Sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR) and diagnostic odds ratio (DOR), the summary receiver operator characteristic (SROC) curve and the calculated AUC (area under the SROC curve) were applied to explore the diagnostic accuracy of miRNAs in metastasis. Seven hundred seventy-one metastatic cancer patients and 552 non-metastatic cancer controls from 14 articles were involved in our meta-analysis. A sensitivity of 0.75 (95% confidence interval (CI), 0.72-0.79) and a specificity of 0.80 (95% CI, 0.76-0.84) were observed from metastatic patients and non-metastatic controls in the combined analysis. And the AUC was 0.83 (95% CI, 0.79-0.86). In addition, results from subgroup analyses suggested that a higher diagnostic value for metastasis was acquired in tissue sample other than blood sample (sensitivity, 0.82 versus 0.73; specificity, 0.84 versus 0.79; PLR, 5.0 versus 3.5; NLR, 0.22 versus 0.34; DOR, 23 versus 10; AUC, 0.88 versus 0.80). In summary, this meta-analysis proved the relatively high diagnostic value of miRNA in metastasis, which might be applied as a novel screening tool to detect metastasis along with other biomarkers. We also illustrated that tissue-based miRNAs may have a better diagnostic accuracy than blood-based miRNAs.
癌症的低生存率主要归因于诊断延迟和转移。鉴别转移是癌症患者预后和提高生存率的关键因素。微小RNA（miRNA）可调节数百个下游基因的表达，对整个细胞周期的调控具有广泛影响。越来越多的研究发现，miRNA的异常表达与癌症发生有关。本研究旨在评估miRNA在检测癌症转移中的诊断价值。检索了Medline、PubMed、Embase和中国知网（CNKI）以获取相关文章。应用敏感性、特异性、阳性和阴性似然比（PLR、NLR）以及诊断比值比（DOR）、汇总接受者操作特征（SROC）曲线和计算得到的曲线下面积（AUC）来探讨miRNA在转移诊断中的准确性。我们的荟萃分析纳入了来自14篇文章的771例转移性癌症患者和552例非转移性癌症对照。在合并分析中，转移性患者和非转移性对照的敏感性为0.75（95%置信区间（CI），0.72 - 0.79），特异性为0.80（95%CI，0.76 - 0.84）。AUC为0.83（95%CI，0.79 - 0.86）。此外，亚组分析结果表明，在组织样本中对转移的诊断价值高于血液样本（敏感性，0.82对0.73；特异性，0.84对0.79；PLR，5.0对3.5；NLR，0.22对0.34；DOR，23对10；AUC，0.88对0.80）。总之，这项荟萃分析证明了miRNA在转移诊断中具有较高的诊断价值，其可能作为一种新型筛查工具与其他生物标志物一起用于检测转移。我们还表明，基于组织的miRNA可能比基于血液的miRNA具有更好的诊断准确性。
