Wang Huoqiang, Wu Songnian, Zhao Long, Zhao Juan, Liu Jinjun, Wang Zhihao
Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Respirology. 2015 Jan;20(1):56-65. doi: 10.1111/resp.12444. Epub 2014 Dec 1.
Emerging studies have revealed that microRNA (miRNA) in body fluid may serve as a potential biomarker to detect non-small cell lung cancer (NSCLC). However, the diagnostic accuracy of miRNA for NSCLC detection is still under debate because there is inconsistency in previous studies. Hence, we conducted this meta-analysis to comprehensively evaluate the diagnostic performance of miRNA. A systematic literature search was performed to retrieve relevant articles in PubMed and other databases, and STATA 12.0 (StataCorp, College Station, TX, USA) was used to calculate the pooled parameters. A total of 28 articles involving 2121 NSCLC patients and 1582 healthy controls were included in this meta-analysis. The overall pooled sensitivity and specificity of miRNA were 0.75 and 0.79, respectively. The pooled positive likelihood ratio was 3.6, negative likelihood ratio was 0.32 and diagnostic odds ratio was 12. The area under the curve (AUC) was 0.84. Subgroup and meta-regression analyses established that miRNA assays were more accurate in Caucasian populations (AUC of 0.86, sensitivity of 0.79 and specificity of 0.82, respectively) than in Asian populations (AUC, sensitivity and specificity of 0.83, 0.72 and 0.80, respectively). In addition, the multiple miRNA assays (AUC of 0.89, sensitivity of 0.83 and specificity of 0.82, respectively) showed a higher accuracy than single miRNA assays (AUC, sensitivity and specificity of 0.81, 0.77 and 0.71, respectively) in NSCLC detection. Subgroup analyses based on specimen types suggested that blood-based miRNA (AUC of 0.86, sensitivity of 0.78 and specificity of 0.80, respectively) may have a higher diagnostic accuracy as biomarkers than sputum-based miRNA (AUC of 0.81, sensitivity of 0.69 and specificity of 0.80, respectively). In conclusion, miRNA may serve as a potential biomarker in NSCLS detection, especially the multiple miRNA from blood, with a relatively high diagnostic accuracy.
新兴研究表明，体液中的微小RNA（miRNA）可能作为检测非小细胞肺癌（NSCLC）的潜在生物标志物。然而，由于先前研究结果不一致，miRNA用于NSCLC检测的诊断准确性仍存在争议。因此，我们进行了这项荟萃分析，以全面评估miRNA的诊断性能。通过系统检索PubMed和其他数据库中的相关文章，并使用STATA 12.0（美国德克萨斯州大学站市StataCorp公司）计算合并参数。本荟萃分析共纳入28篇文章，涉及2121例NSCLC患者和1582例健康对照。miRNA的总体合并敏感性和特异性分别为0.75和0.79。合并阳性似然比为3.6，阴性似然比为0.32，诊断比值比为12。曲线下面积（AUC）为0.84。亚组分析和荟萃回归分析表明，miRNA检测在白种人群中（AUC为0.86，敏感性为0.79，特异性为0.82）比在亚洲人群中（AUC分别为0.83、敏感性为0.72、特异性为0.80）更准确。此外，在NSCLC检测中，多种miRNA检测（AUC为0.89，敏感性为0.83，特异性为0.82）比单一miRNA检测（AUC分别为0.81、敏感性为0.77、特异性为0.71）显示出更高的准确性。基于样本类型的亚组分析表明，作为生物标志物，血液中的miRNA（AUC为0.86，敏感性为0.78，特异性为0.80）可能比痰液中的miRNA（AUC为0.81，敏感性为0.69，特异性为0.80）具有更高的诊断准确性。总之，miRNA可能作为NSCLS检测的潜在生物标志物，尤其是血液中的多种miRNA，具有相对较高的诊断准确性。
