系统评价和荟萃分析用于生存结果的鼻咽癌预后 microRNA 生物标志物。
Systematic review and meta-analysis of prognostic microRNA biomarkers for survival outcome in nasopharyngeal carcinoma.
机构信息
School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India.
University of Adelaide, North Terrace Campus, Adelaide South Australia, Australia.
出版信息
PLoS One. 2019 Feb 8;14(2):e0209760. doi: 10.1371/journal.pone.0209760. eCollection 2019.
BACKGROUND
Nasopharyngeal cancer (NPC), despite being one of the most malignant head and neck carcinomas (HNC), lacks comprehensive prognostic biomarkers that predict patient survival. Therefore, this systematic review and meta-analysis is aimed to evaluate the potential prognostic value of miRNAs as prognostic biomarkers in NPC.
METHODS
PRISMA guidelines were used to conduct this systematic review and meta-analysis study. Permutations of multiple "search key-words" were used for the search strategy, which was limited to articles published between January 2012 and March 2018. The retrieved articles were meticulously searched with multi-level screening by two reviewers and confirmed by other reviewers. Meta-analysis was performed using Hazard Ratios (HR) and associated 95% Confidence Interval (CI) of survival obtained from previously published studies. Publication bias was assessed by Egger's bias indicator test and funnel plot symmetry.
RESULTS
A total of 5069 patients across 21 studies were considered eligible for inclusion in the systematic review, with 65 miRNAs being evaluated in the subsequent meta-analysis. Most articles included in this study originated from China and one study from North Africa. The forest plot was generated using cumulated survival data, resulting in a pooled HR value of 1.196 (95% CI: 0.893-1.601) indicating that the upregulated miRNAs increased the likelihood of death of NPC patients by 19%.
CONCLUSION
To our knowledge, this is the first meta-analysis that examines the prognostic effectiveness of miRNAs as biomarkers in NPC patients. We noted that the combined effect estimate of HR across multiple studies indicated that increased miRNA expression in NPC potentially leads to poor overall survival. However, further large-scale prospective studies on the clinical significance of the miRNAs, with sizable cohorts are necessary in order to obtain conclusive results.
背景
尽管鼻咽癌（NPC）是最恶性的头颈部癌（HNC）之一，但缺乏全面的预后生物标志物来预测患者的生存情况。因此，本系统评价和荟萃分析旨在评估 miRNA 作为 NPC 预后生物标志物的潜在预后价值。
方法
采用 PRISMA 指南进行这项系统评价和荟萃分析研究。使用多种“搜索关键字”组合来制定搜索策略，该策略限于 2012 年 1 月至 2018 年 3 月期间发表的文章。由两位审稿人进行多层次筛选，对检索到的文章进行仔细搜索，并由其他审稿人进行确认。使用从先前发表的研究中获得的风险比（HR）和相关的 95％置信区间（CI）进行荟萃分析。通过 Egger 的偏倚指标检验和漏斗图对称性评估发表偏倚。
结果
共有 21 项研究的 5069 名患者被认为符合纳入本系统评价的标准，随后的荟萃分析评估了 65 种 miRNA。本研究中纳入的大多数文章来自中国，一项来自北非。森林图是使用累积生存数据生成的，得出的合并 HR 值为 1.196（95％CI：0.893-1.601），表明上调的 miRNA 增加了 NPC 患者死亡的可能性 19％。
结论
据我们所知，这是首次荟萃分析检查了 miRNA 作为 NPC 患者生物标志物的预后效果。我们注意到，多项研究的 HR 联合效应估计表明，NPC 中 miRNA 的表达增加可能导致总体生存率降低。然而，需要进一步进行具有大样本量的前瞻性研究，以确定 miRNA 的临床意义，并获得确凿的结果。
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