Cheng Yidong, Deng Xiaheng, Yang Xiao, Li Pengchao, Zhang Xiaolei, Li Peng, Tao Jun, Lu Qiang, Wang Zengjun
Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
Onco Targets Ther. 2015 Aug 11;8:2089-96. doi: 10.2147/OTT.S86908. eCollection 2015.
The diagnostic value of microRNA (miRNA) detection in patients with bladder cancer (BCa) is controversial. We performed a diagnostic meta-analysis to evaluate current evidence on the use of miRNA assays to diagnose BCa.
We systematically searched PubMed, Embase, and Web of Science for studies published before March 31, 2015. The pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and area under the curve (AUC) were calculated to evaluate the overall test performance. Subgroup analyses were used to explore the between-study heterogeneity. Deeks' funnel plot asymmetry test was used to test publication bias. We applied the software of RevMan 5.2 and Stata 11.0 to the meta-analysis.
A total of 23 studies from nine articles were included in the meta-analysis, with a total of 719 patients and 494 controls. The pooled sensitivity and specificity were 0.75 (95% confidence interval [CI], 0.68-0.80) and 0.75 (95% CI, 0.70-0.80), respectively. The pooled positive likelihood ratio was 3.03 (95% CI, 2.50-3.67); negative likelihood ratio was 0.33 (95% CI, 0.27-0.42); and diagnostic odds ratio was 9.07 (95% CI, 6.35-12.95). The pooled AUC was 0.81 (95% CI, 0.78-0.85). Subgroup analyses indicated that the multiple miRNAs assays and urine supernatant assays showed high accuracies in diagnosing BCa.
The miRNA assays may serve as potential noninvasive diagnostic tool for the detection of BCa. However, the clinical application of miRNA assays for BCa diagnosis still needs further validation by large prospective studies.
微小RNA（miRNA）检测在膀胱癌（BCa）患者中的诊断价值存在争议。我们进行了一项诊断性荟萃分析，以评估目前关于使用miRNA检测诊断BCa的证据。
我们系统检索了PubMed、Embase和Web of Science中2015年3月31日前发表的研究。计算合并敏感度、特异度、阳性和阴性似然比、诊断比值比以及曲线下面积（AUC），以评估总体检测性能。进行亚组分析以探讨研究间的异质性。使用Deeks漏斗图不对称性检验来检测发表偏倚。我们将RevMan 5.2和Stata 11.0软件应用于荟萃分析。
荟萃分析共纳入9篇文章中的23项研究，共计719例患者和494例对照。合并敏感度和特异度分别为0.75（95%置信区间[CI]，0.68 - 0.80）和0.75（95%CI，0.70 - 0.80）。合并阳性似然比为3.03（95%CI，2.50 - 3.67）；阴性似然比为0.33（95%CI，0.27 - 0.42）；诊断比值比为9.07（95%CI，6.35 - 12.95）。合并AUC为0.81（95%CI，0.78 - 0.85）。亚组分析表明，多种miRNA检测和尿上清液检测在诊断BCa方面显示出较高的准确性。
miRNA检测可能作为检测BCa的潜在非侵入性诊断工具。然而，miRNA检测在BCa诊断中的临床应用仍需大型前瞻性研究进一步验证。
