Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China.
School of Pharmacy, Lanzhou University, Lanzhou, Gansu 730000, P.R. China.
Oncol Rep. 2019 Jan;41(1):87-102. doi: 10.3892/or.2018.6782. Epub 2018 Oct 11.
Recently, cancer research microRNA studies have drawn great attention. However, the results of these studies have been inconsistent and variable regarding the availability of circulating miRNAs in gastric cancer (GC) diagnosis. Thus, results should be interpreted cautiously. The purpose of the present study was to assess the diagnostic performance of circulating miRNAs in GC diagnosis. We conducted a systematic and comprehensive approach for the inclusion of studies. The sensitivity, specificity, and diagnostic odds ratio were pooled with random effects models, and a summary of receiver operator characteristic (SROC) curves were plotted. The potential heterogeneity was assessed with Q test and I2 statistics. Subgroup analyses and meta‑regressions further investigated the sources of heterogeneity. A total of 77 studies from 48 articles were eligible for the meta‑analysis. The results revealed a sensitivity of 0.76, a specificity of 0.81, and an AUC of 0.86 for gastric cancer diagnosis with circulating miRNAs. In addition, subgroup analyses indicated that multiple miRNAs assays, non‑microarray screening approaches, and serum‑based miRNA assays exhibited good diagnostic performance in contrast to a single miRNA assay, microarray expression profiling screening, and plasma‑based miRNA group analysis. The diagnostic ability of miRNAs in early stage I‑II groups and the high expression group were approximately similar to that in the stage I‑IV groups and the low expression group. For the circulating miRNAs, our meta‑analysis identified a combination of multiple miRNAs, non‑microarray chip screening, and serum‑based miRNA assays were associated with the most effective GC diagnostic performance. However, many unclear molecular mechanisms limited the accuracy of the diagnostic results, and should be interpreted with caution. Further large‑scale prospective studies are required for validating the diagnostic applicability of circulating miRNAs in gastric cancer patients.
最近，癌症研究中的 microRNA 研究引起了极大的关注。然而，关于循环 microRNA 在胃癌（GC）诊断中的可用性，这些研究的结果不一致且多变。因此，结果应谨慎解释。本研究旨在评估循环 microRNA 在 GC 诊断中的诊断性能。我们采用系统全面的方法纳入研究。使用随机效应模型汇总了敏感性、特异性和诊断优势比，并绘制了汇总受试者工作特征（SROC）曲线。使用 Q 检验和 I2 统计量评估潜在异质性。亚组分析和荟萃回归进一步研究了异质性的来源。共有 48 篇文章中的 77 项研究符合荟萃分析的条件。结果显示，循环 microRNA 诊断胃癌的敏感性为 0.76，特异性为 0.81，AUC 为 0.86。此外，亚组分析表明，与单个 microRNA 检测、微阵列表达谱筛选和基于血浆的 microRNA 组分析相比，多个 microRNA 检测、非微阵列筛选方法和基于血清的 microRNA 检测具有良好的诊断性能。在早期 I-II 期组和高表达组中，miRNA 的诊断能力与在 I-IV 期组和低表达组中大致相似。对于循环 microRNA，我们的荟萃分析确定了多种 microRNA 的组合、非微阵列芯片筛选和基于血清的 microRNA 检测与最有效的 GC 诊断性能相关。然而，许多不清楚的分子机制限制了诊断结果的准确性，应谨慎解释。需要进一步的大规模前瞻性研究来验证循环 microRNA 在胃癌患者中的诊断适用性。
