Zhang Xiaoyun, Wang Qian, Zhang Shijie
Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University.
Department of Medical Laboratory, Fuwai Central China Cardiovascular Hospital, Zhengzhou, Henan Province, China.
Medicine (Baltimore). 2019 Feb;98(6):e14337. doi: 10.1097/MD.0000000000014337.
Nonsmall cell lung cancer (NSCLC) is a serious leading cause of death worldwide. Recently, multiple researches have identified that microRNA (miRNA) in sputum could be a useful tool for NSCLC diagnosis. The objective of this study was to assess whether aberrant miRNA expression could be regarded as a useful biomarker in sputum specimen for the diagnosis of NSCLC.
Eligible studies were searched in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases up to June 2018. We calculated the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) to investigate the diagnostic value of miRNA in sputum for NSCLC. MetaDisc1.4 and STATA12.0 were used to analyze the retrieved data.
Finally, a total of 14 articles were included in this meta-analysis involving 1009 NSCLC patients and 1006 controls. The results were as followed: the pooled sensitivity, specificity, PLR, NLR, DOR, were 0.75 (95%CI:0.72-0.78), 0.88 (95%CI:0.86-0.90), 5.70 (95%CI:4.82-6.75), 0.30 (95%CI:0.26-0.34), 22.43 (95%CI:17.48-28.79), respectively. The AUC of overall summary receiver operator characteristic curve (SROC) was 0.8917.
Our comprehensive analysis indicated that miRNAs in sputum specimen may be noninvasive diagnostic biomarkers for NSCLC. However, much more studies should be conducted before clinical application.
非小细胞肺癌（NSCLC）是全球范围内主要的严重致死原因。最近，多项研究表明痰液中的微小RNA（miRNA）可能是NSCLC诊断的有用工具。本研究的目的是评估miRNA表达异常是否可被视为痰液标本中NSCLC诊断的有用生物标志物。
截至2018年6月，在PubMed、科学网、中国知网（CNKI）、万方和维普数据库中检索符合条件的研究。我们计算了合并敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）和曲线下面积（AUC），以研究痰液中miRNA对NSCLC的诊断价值。使用MetaDisc1.4和STATA12.0分析检索到的数据。
最终，本荟萃分析共纳入14篇文章，涉及1009例NSCLC患者和1006例对照。结果如下：合并敏感性、特异性、PLR、NLR、DOR分别为0.75（95%CI：0.72 - 0.78）、0.88（95%CI：0.86 - 0.90）、5.70（95%CI：4.82 - 6.75）、0.30（95%CI：0.26 - 0.34）、22.43（95%CI：17.48 - 28.79）。总体综合受试者工作特征曲线（SROC）的AUC为0.8917。
我们的综合分析表明，痰液标本中的miRNA可能是NSCLC的非侵入性诊断生物标志物。然而，在临床应用之前还需要进行更多的研究。
