Liu Hai-Ning, Wu Hao, Chen Yan-Jie, Tseng Yu-Jen, Bilegsaikhan Enkhnaran, Dong Ling, Shen Xi-Zhong, Liu Tao-Tao
Department of Gastroenterology, Zhongshan Hospital of Fudan University, Shanghai 200032, China.
Shanghai Institute of Liver Diseases, Zhongshan Hospital of Fudan University, Shanghai 200032, China.
Oncotarget. 2017 Nov 1;8(65):108810-108824. doi: 10.18632/oncotarget.22224. eCollection 2017 Dec 12.
Many new diagnostic biomarkers have been developed for hepatocellular carcinoma (HCC). We selected two methods with high diagnostic value, the detection of serum microRNAs and metabolomics based on gas chromatography/mass spectrometry (GC/MS), and attempted to establish appropriate models.
We reviewed the diagnostic efficiencies of all microRNAs identified by previous diagnostic tests. Then we chose appropriate microRNAs to validate the diagnostic efficiencies, and determined the optimal combination. We included 66 patients with HCC and 82 healthy controls (HCs) and detected the expression of the microRNAs. GC/MS analysis was performed, and we used three multivariate statistical methods to establish diagnostic models. The concentration of alpha feto-protein (AFP) was determined for comparison with the novel models.
82 published studies and 92 microRNAs were ultimately included in this systematic review. Seven microRNAs were selected for further validation of their diagnostic efficiencies. Among which, miR-21, miR-106b, miR-125b, miR-182 and miR-224 had a significantly different expression in HCC patients. The combination of miR-21, miR-106b and miR-224 had the highest area under the curve (AUC) at 0.950 with a sensitivity of 80.3% and a specificity of 92.7%. The GC/MS analysis exhibited an excellent diagnostic value and the AUC reached 1.0. In comparison, the AUC of the traditional biomarker, AFP, was 0.755.
MicroRNAs and metabolomics shows promising potential as new diagnostic methods due to their high diagnostic value compared with traditional biomarkers.
已经开发出许多用于肝细胞癌（HCC）的新型诊断生物标志物。我们选择了两种具有高诊断价值的方法，即血清微小RNA检测和基于气相色谱/质谱（GC/MS）的代谢组学，并试图建立合适的模型。
我们回顾了先前诊断试验中鉴定出的所有微小RNA的诊断效率。然后我们选择合适的微小RNA来验证诊断效率，并确定最佳组合。我们纳入了66例HCC患者和82例健康对照（HCs），并检测了微小RNA的表达。进行了GC/MS分析，我们使用三种多元统计方法建立诊断模型。测定甲胎蛋白（AFP）的浓度以与新模型进行比较。
本系统评价最终纳入了82项已发表的研究和92种微小RNA。选择了7种微小RNA进一步验证其诊断效率。其中，miR-21、miR-106b、miR-125b、miR-182和miR-224在HCC患者中表达有显著差异。miR-21、miR-106b和miR-224的组合曲线下面积（AUC）最高，为0.950，敏感性为80.3%，特异性为92.7%。GC/MS分析显示出优异的诊断价值，AUC达到1.0。相比之下，传统生物标志物AFP的AUC为0.755。
与传统生物标志物相比，微小RNA和代谢组学因其高诊断价值而显示出作为新诊断方法的广阔前景。
