Chen Liangyuan, Cui Zhaolei, Liu Yaohua, Bai Ye, Lan Fenghua
Clin Lab. 2015;61(8):1101-8. doi: 10.7754/clin.lab.2015.150204.
Bladder cancer (BCa) is the fifth most common cancer with significant morbidity and mortality. Recently, numerous studies demonstrated that microRNAs (miRNAs) are emerging as diagnostic biomarkers for BCa. However, the findings in these studies are inconsistent. To systematically assess the potential diagnostic value of miRNAs for BCa, a meta-analysis was performed in this study.
Relevant literature was researched in PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and WanFang databases up to September 1, 2014. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative LR (NLR), diagnostic odds ratio (DOR), and area under the SROC curve (AUC) value were analyzed by the random-effects model, whose parameters reflected the overall diagnostic performance of miRNAs.
Thirty studies from 10 individual publications, including 1019 BCa patients and 690 controls, were included in this meta-analysis. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.80 (95% CI: 0.78 - 0.81), 0.74 (95% CI: 0.72 - 0.76), 3.22 (95% CI: 2.68 - 3.87), 0.26 (95% CI: 0.21 - 0.32), 15.20 (95% CI: 10.25 - 22.53) and 0.85, respectively, indicating a moderate diagnostic accuracy for BCa. Moreover, our subgroup analyses showed that analysis of multiple miRNAs (AUC, sensitivity, and specificity of 0.913, 0.86, and 0.80, respectively) yielded a higher diagnostic accuracy than of single miRNAs (AUC, sensitivity, and specificity of 0.84, 0.78, and 0.73, respectively) in BCa diagnosis. In addition, as biomarkers, miRNAs are more suitable for the diagnosis of non-muscle-invasive BCa (NMIBCa) with AUC of 0.84, sensitivity of 0.74, and specificity of 0.77 than muscle-invasive BCa (MIBCa) with AUC of 0.79, sensitivity of 0.73, and specificity of 0.73.
The present meta-analysis suggests that miRNAs are potential novel biomarkers for detection of BCa. However, further validation studies are still needed to confirm our findings.
膀胱癌（BCa）是第五大常见癌症，具有较高的发病率和死亡率。最近，大量研究表明，微小RNA（miRNA）正成为膀胱癌的诊断生物标志物。然而，这些研究的结果并不一致。为了系统评估miRNA对膀胱癌的潜在诊断价值，本研究进行了一项荟萃分析。
截至2014年9月1日，在PubMed、Embase、Cochrane图书馆、中国国家知识基础设施（CNKI）和万方数据库中检索相关文献。采用随机效应模型分析合并敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）和SROC曲线下面积（AUC）值，其参数反映了miRNA的总体诊断性能。
本荟萃分析纳入了来自10篇独立出版物的30项研究，包括1019例膀胱癌患者和690例对照。合并敏感性、特异性、PLR、NLR、DOR和AUC分别为0.80（95%CI：0.78 - 0.81）、0.74（95%CI：0.72 - 0.76）、3.22（95%CI：2.68 - 3.87）、0.26（95%CI：0.21 - 0.32）、15.20（95%CI：10.25 - 22.53）和0.85，表明对膀胱癌具有中等诊断准确性。此外，我们的亚组分析表明，在膀胱癌诊断中，分析多个miRNA（AUC、敏感性和特异性分别为0.913、0.86和0.80）比分析单个miRNA（AUC、敏感性和特异性分别为0.84、0.78和0.73）具有更高的诊断准确性。此外，作为生物标志物，miRNA更适合诊断非肌层浸润性膀胱癌（NMIBCa），其AUC为0.84，敏感性为0.74，特异性为0.77，而对于肌层浸润性膀胱癌（MIBCa），AUC为0.79，敏感性为0.73，特异性为0.73。
本荟萃分析表明，miRNA是检测膀胱癌的潜在新型生物标志物。然而，仍需要进一步的验证研究来证实我们的发现。
