Wu Kailiu, Li Liwen, Li Siyi
Department of Oral and Maxillofacial-head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.
Tumour Biol. 2015 Mar;36(3):1973-81. doi: 10.1007/s13277-014-2803-2. Epub 2014 Dec 20.
Cancer is a class of diseases with high mortality rate, characterized by unregulated cell growth. Early diagnosis of cancer is currently the most effective method to prevent cancer development and improve the survival rate of patients. Traditional diagnostic methods such as biopsy usually provoke discomfort and unpleasant experience. Recently, microRNAs (miRNAs) were widely reported to be potential biomarkers to detect cancers without invasiveness. MicroRNA-21 (miRNA-21, miR-21) is one of the most prevalent miRNAs. This meta-analysis aims to make a comprehensive analysis of the potential role of circulating miR-21 as a biomarker in human carcinoma diagnosis. A total of 36 articles involving 2920 cancer patients and 1986 healthy controls with regard to the diagnostic value of the circulating miR-21 for cancer detection were selected from online bibliographic databases. For pooled analysis, the sensitivity, specificity, and other basic characteristics were extracted from the 36 included articles. Then, bivariate random-effects model was selected to gain pooled results. Furthermore, to explore the sources of heterogeneity, we conducted stratified and meta-regression analyses based on different race/sample groups. The pooled characteristics of all included articles were as follows: sensitivity, 0.78 (95% confidence intervals (CI), 0.73-0.82); specificity, 0.82 (95% CI, 0.79-0.86); positive likelihood ratio (PLR), 4.4 (95% CI, 3.6-5.4); negative likelihood ratio (NLR), 0.26 (95% CI, 0.21-0.33); diagnostic odds ratio (DOR), 17 (95% CI, 12-24); and area under the curve (AUC), 0.87 (95% CI, 0.84-0.90). The subgroup analyses results based on different ethnic populations revealed that the diagnostic accuracy of miR-21 tends to be higher in Asian populations than in Caucasian populations. Furthermore, another subgroup analysis performed on sample types suggested that the serum-based specimen used in cancer diagnosis appeared to be more accurate than the plasma-based specimen. Our meta-analysis shows that the circulating miR-21 may be a potential biomarker as diagnostic tool for early-stage cancer diagnosis.
癌症是一类死亡率很高的疾病，其特征是细胞生长失控。癌症的早期诊断是目前预防癌症发展和提高患者生存率的最有效方法。传统的诊断方法如活检通常会引起不适和不愉快的体验。最近，有广泛报道称微小RNA（miRNA）是检测癌症的潜在生物标志物，且具有非侵入性。微小RNA-21（miRNA-21，miR-21）是最普遍的miRNA之一。本荟萃分析旨在全面分析循环miR-21作为生物标志物在人类癌症诊断中的潜在作用。从在线文献数据库中筛选出36篇涉及2920例癌症患者和1986例健康对照的关于循环miR-21对癌症检测诊断价值的文章。对于汇总分析，从36篇纳入文章中提取敏感性、特异性和其他基本特征。然后，选择双变量随机效应模型以获得汇总结果。此外，为了探索异质性来源，我们基于不同种族/样本组进行了分层和荟萃回归分析。所有纳入文章的汇总特征如下：敏感性为0.78（95%置信区间（CI），0.73 - 0.82）；特异性为0.82（95%CI，0.79 - 0.86）；阳性似然比（PLR）为4.4（95%CI，3.6 - 5.4）；阴性似然比（NLR）为0.26（95%CI，0.21 - 0.33）；诊断比值比（DOR）为17（95%CI，12 - 24）；曲线下面积（AUC）为0.87（95%CI，0.84 - 0.90）。基于不同种族人群的亚组分析结果显示，miR-21在亚洲人群中的诊断准确性往往高于白种人群。此外，对样本类型进行的另一项亚组分析表明，用于癌症诊断的基于血清的标本似乎比基于血浆的标本更准确。我们的荟萃分析表明，循环miR-21可能是一种潜在的生物标志物，可作为早期癌症诊断的工具。
