Rokkas Theodore, Kothonas Fotis, Rokka Androniki, Koukoulis Georgios, Symvoulakis Emmanuel
Gastroenterology Clinic, Henry Dunant Hospital Center, Athens, Greece.
Eur J Gastroenterol Hepatol. 2015 Jul;27(7):819-25. doi: 10.1097/MEG.0000000000000363.
Several microRNAs (miRNAs) have been identified as potential circulating biomarkers in a number of different cancers including colorectal cancer (CRC). This study aims to assess the diagnostic performance of circulating miRNAs in detecting CRC through meta-analysis of all eligible relevant studies.
An extensive literature search was performed and studies that estimated the diagnostic accuracy of miRNAs in CRC were identified. Data from the eligible studies were collected and pooled; sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratios, weighted symmetric summary ROC curve and the area under the curve (AUC) were calculated. Heterogeneity was evaluated using the Q-test and I(2)-statistics. In addition, subgroup analyses and meta-regression analyses were carried out to explore the potential sources of significant heterogeneity.
A total of 16 studies were included in the meta-analysis according to the inclusion criteria. The overall analysis showed that circulating miRNAs have a relatively good diagnostic performance in CRC, with a sensitivity of 78%, a specificity of 79% and an AUC of 0.87. Subgroup analyses showed that a single miRNA-21 test, as opposed to a panel miRNAs test, significantly improved the diagnostic accuracy with 83.4% sensitivity, 91.6% specificity, and AUC increasing to 0.94.
Circulating miRNAs, especially miRNA-21, are promising diagnostic biomarkers in CRC. However, more prospective studies are required to further explore their diagnostic role and their usefulness in clinical practice.
在包括结直肠癌（CRC）在内的多种不同癌症中，几种微小RNA（miRNA）已被确定为潜在的循环生物标志物。本研究旨在通过对所有符合条件的相关研究进行荟萃分析，评估循环miRNA在检测CRC中的诊断性能。
进行了广泛的文献检索，确定了评估miRNA在CRC中诊断准确性的研究。收集并汇总符合条件的研究数据；计算敏感性、特异性、阳性和阴性似然比、诊断比值比、加权对称汇总ROC曲线和曲线下面积（AUC）。使用Q检验和I²统计量评估异质性。此外，进行亚组分析和荟萃回归分析以探索显著异质性的潜在来源。
根据纳入标准，共有16项研究纳入荟萃分析。总体分析表明，循环miRNA在CRC中具有相对较好的诊断性能，敏感性为78%，特异性为79%，AUC为0.87。亚组分析表明，与miRNA组合检测相比，单一miRNA-21检测显著提高了诊断准确性，敏感性为83.4%，特异性为91.6%，AUC增至0.94。
循环miRNA，尤其是miRNA-21，是CRC中有前景的诊断生物标志物。然而，需要更多的前瞻性研究来进一步探索它们的诊断作用及其在临床实践中的实用性。
