Peng Qiliang, Zhang Xueli, Min Ming, Zou Li, Shen Peipei, Zhu Yaqun
Department of Radiotherapy & Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China.
Institute of Radiotherapy & Oncology, Soochow University, Suzhou, China.
Oncotarget. 2017 Jul 4;8(27):44893-44909. doi: 10.18632/oncotarget.16488.
This systematic analysis aimed to investigate the value of microRNA-21 (miR-21) in colorectal cancer for multiple purposes, including diagnosis and prognosis, as well as its predictive power in combination biomarkers. Fifty-seven eligible studies were included in our meta-analysis, including 25 studies for diagnostic meta-analysis and 32 for prognostic meta-analysis. For the diagnostic meta-analysis of miR-21 alone, the overall pooled results for sensitivity, specificity, and area under the curve (AUC) were 0.64 (95% CI: 0.53-0.74), 0.85 (0.79-0.90), and 0.85 (0.81-0.87), respectively. Circulating samples presented corresponding values of 0.72 (0.63-0.79), 0.84 (0.78-0.89), and 0.86 (0.83-0.89), respectively. For the diagnostic meta-analysis of miR-21-related combination biomarkers, the above three parameters were 0.79 (0.69-0.86), 0.79 (0.68-0.87), and 0.86 (0.83-0.89), respectively. Notably, subgroup analysis suggested that miRNA combination markers in circulation exhibited high predictive power, with sensitivity of 0.85 (0.70-0.93), specificity of 0.86 (0.77-0.92), and AUC of 0.92 (0.89-0.94). For the prognostic meta-analysis, patients with higher expression of miR-21 had significant shorter disease-free survival [DFS; pooled hazard ratio (HR): 1.60; 95% CI: 1.20-2.15] and overall survival (OS; 1.54; 1.27-1.86). The combined HR in tissues for DFS and OS were 1.76 (1.31-2.36) and 1.58 (1.30-1.93), respectively. Our comprehensive systematic review revealed that circulating miR-21 may be suitable as a diagnostic biomarker, while tissue miR-21 could be a prognostic marker for colorectal cancer. In addition, miRNA combination biomarkers may provide a new approach for clinical application.
本系统分析旨在探讨微小RNA-21（miR-21）在结直肠癌中的多种价值，包括诊断和预后价值，以及其在联合生物标志物中的预测能力。我们的荟萃分析纳入了57项符合条件的研究，其中25项用于诊断性荟萃分析，32项用于预后性荟萃分析。对于单独miR-21的诊断性荟萃分析，敏感性、特异性和曲线下面积（AUC）的总体合并结果分别为0.64（95%CI：0.53-0.74）、0.85（0.79-0.90）和0.85（0.81-0.87）。循环样本的相应值分别为0.72（0.63-0.79）、0.84（0.78-0.89）和0.86（0.83-0.89）。对于miR-21相关联合生物标志物的诊断性荟萃分析，上述三个参数分别为0.79（0.69-0.86）、0.79（0.68-0.87）和0.86（0.83-0.89）。值得注意的是，亚组分析表明，循环中的miRNA联合标志物具有较高的预测能力，敏感性为0.85（0.70-0.93），特异性为0.86（0.77-0.92），AUC为0.92（0.89-0.94）。对于预后性荟萃分析，miR-21表达较高的患者无病生存期[DFS；合并风险比（HR）：1.60；95%CI：1.20-2.15]和总生存期（OS；1.54；1.27-1.86）显著缩短。组织中DFS和OS的合并HR分别为1.76（1.31-2.36）和1.58（1.30-1.93）。我们全面的系统评价表明，循环miR-21可能适合作为诊断生物标志物，而组织miR-21可能是结直肠癌的预后标志物。此外，miRNA联合生物标志物可能为临床应用提供一种新方法。
