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尿微小RNA作为膀胱癌非侵入性生物标志物的诊断价值:一项荟萃分析。

Diagnostic value of urinary microRNAs as non-invasive biomarkers for bladder cancer: a meta-analysis.

作者信息

Ding Mingxia, Li Yi, Wang Haifeng, Lv Yongchang, Liang Jianwei, Wang Jiansong, Li Chong

机构信息

Department of Urology, The Second Affiliated Hospital of Kunming Medical University Kunming 650101, China.

Department of Anesthesiology, Peking University Third Hospital Beijing 100083, China.

出版信息

Int J Clin Exp Med. 2015 Sep 15;8(9):15432-40. eCollection 2015.

Abstract

BACKGROUND

Bladder cancer (BC) is the fifth most common malignancy worldwide. The expression levels of microRNAs (miRNAs) in urine samples of BC patients have been demonstrated to be different from healthy people. Several studies focusing on the diagnostic value of urinary miRNAs for BC detection have been reported. The aim of this meta-analysis was to access the overall diagnostic accuracy comprehensively and quantitatively.

METHODS

PubMed, Embase, Web of Science, the Cochrane Library, and CNKI were searched without language restrictions for studies about the diagnostic value of miRNAs for BC. The pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR) were calculated using the random effects model. The summary receiver operating characteristic (SROC) curve was also generated and the area under the curve (AUC) was also reckoned to assess the diagnosis accuracy. Besides, Chi-square test and I(2) test were used to assess the heterogeneity between studies. Publication bias was evaluated by the Deeks' funnel plot asymmetry test.

RESULTS

Fourteen studies were included in this meta-analysis, with a total of 1,128 BC patients and 1,057 matched controls. The overall sensitivity, specificity, PLR, NLR and DOR of urinary miRNAs for the diagnosis of BC were 0.71 (95% CI: 0.67-0.75), 0.75 (95% CI: 0.70-0.79), 2.8 (95% CI: 2.3-3.4), 0.39 (95% CI: 0.33-0.46) and 7 (95% CI: 5-10), respectively. The area under the SROC curve was 0.79. Subgroup analyses suggested that the ethnicity and miRNA profiling had an obvious influence on the diagnostic accuracy.

CONCLUSION

The current analysis suggested that urinary miRNA panels may be a promising noninvasive biomarker in the diagnosis of BC.

摘要

背景

膀胱癌(BC)是全球第五大常见恶性肿瘤。已证实膀胱癌患者尿液样本中微小RNA(miRNA)的表达水平与健康人不同。已有多项关于尿液miRNA对膀胱癌检测诊断价值的研究报道。本荟萃分析的目的是全面、定量地评估总体诊断准确性。

方法

对PubMed、Embase、Web of Science、Cochrane图书馆和中国知网进行检索,不限语言,查找有关miRNA对膀胱癌诊断价值的研究。采用随机效应模型计算合并敏感度、特异度、阳性和阴性似然比(分别为PLR和NLR)、诊断比值比(DOR)。还生成了汇总的受试者工作特征(SROC)曲线,并计算曲线下面积(AUC)以评估诊断准确性。此外,采用卡方检验和I²检验评估研究间的异质性。通过Deeks漏斗图不对称性检验评估发表偏倚。

结果

本荟萃分析纳入了14项研究,共1128例膀胱癌患者和1057例匹配对照。尿液miRNA诊断膀胱癌的总体敏感度、特异度、PLR、NLR和DOR分别为0.71(95%CI:0.67 - 0.75)、0.75(95%CI:0.70 - 0.79)、2.8(95%CI:2.3 - 3.4)、0.39(95%CI:0.33 - 0.46)和7(95%CI:5 - 10)。SROC曲线下面积为0.79。亚组分析表明,种族和miRNA谱对诊断准确性有明显影响。

结论

当前分析表明,尿液miRNA检测可能是膀胱癌诊断中有前景的非侵入性生物标志物。

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