Lin Ni, Lin Yazhen, Fu Xiaodan, Wu Chuncai, Xu Jianping, Cui Zhaolei, Lin Donghong
Clin Lab. 2016;62(3):451-61. doi: 10.7754/clin.lab.2015.150802.
Recent studies have highlighted the potential diagnostic values of microRNAs (miRNA) in various cancers involving oral cancer. This meta-analysis sought to summarize the global diagnostic accuracy of miRNAs for patients with oral cancer (OC).
A systematic review of multiple databases was performed to obtain original studies fulfilling search criteria and the quality of studies was assessed by the QUADAS tool. The bivariate meta-analysis model was employed to plot the summary receiver operator characteristic (SROC) curve. Influence analysis, meta-regression, and publication bias assay were all conducted using Stata 12.0 software. The trim-fill adjustment method was used to further assess the possible effect of publication bias.
A total of 8 studies were included. The SROC analysis showed that miRNA profiling allowed for the discrimination between patients with high-risk oral lesions (OC or pre-cancer) and healthy donors, with a sensitivity of 0.84 (95% CI: 0.78-0.88) and specificity of 0.83 (95% CI: 0.78-0.87), corresponding to an area under curve (AUC) of 0.90. Our subgroup analyses suggested that miRNA signature harbored higher accuracy in diagnosing oral squamous cell carcinoma (OSCC) than pre-cancer lesions (AUC, sensitivity, and specificity of 0.90, 0.83, or 0.82, respectively). Moreover, stratified analyses revealed that parallel miRNA profiling, plasma- and Caucasian-based analyses all conferred promising accuracies for OC detection. The funnel plot assay manifested evidence of a publication bias. After the adjustment by the trim and fill method, the pooled adjusted efforts were slightly attenuated.
MiRNA profiles hallmark a potential diagnostic value for detection of OC and potentially malignant disorders. Further studies should be performed to rigorously evaluate the diagnostic accuracy of miRNA profiling for OC.
近期研究凸显了微小RNA（miRNA）在包括口腔癌在内的多种癌症中的潜在诊断价值。本荟萃分析旨在总结miRNA对口腔癌（OC）患者的总体诊断准确性。
对多个数据库进行系统综述，以获取符合检索标准的原始研究，并使用QUADAS工具评估研究质量。采用双变量荟萃分析模型绘制汇总受试者工作特征（SROC）曲线。使用Stata 12.0软件进行影响分析、荟萃回归和发表偏倚分析。采用修剪填充调整方法进一步评估发表偏倚的可能影响。
共纳入8项研究。SROC分析表明，miRNA谱有助于区分高危口腔病变（OC或癌前病变）患者和健康供体，敏感性为0.84（95%CI：0.78 - 0.88），特异性为0.83（95%CI：0.78 - 0.87），曲线下面积（AUC）为0.90。我们的亚组分析表明，miRNA特征在诊断口腔鳞状细胞癌（OSCC）方面比癌前病变具有更高的准确性（AUC、敏感性和特异性分别为0.90、0.83或0.82）。此外，分层分析显示，平行miRNA谱分析、基于血浆和白种人的分析对OC检测均具有良好的准确性。漏斗图分析显示存在发表偏倚的证据。采用修剪填充法调整后，合并调整后的效应略有减弱。
MiRNA谱对OC和潜在恶性疾病的检测具有潜在诊断价值。应进行进一步研究以严格评估miRNA谱对OC的诊断准确性。
