North Terrace Campus, University of Adelaide, Adelaide, South Australia 5005, Australia.
School of Bio Science and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India.
Cells. 2019 Jul 25;8(8):772. doi: 10.3390/cells8080772.
Head and Neck Cancer (HNC) is the sixth most common type of cancer across the globe, with more than 300,000 deaths each year, globally. However, there are currently no standardised molecular markers that assist in determining HNC prognosis. The literature for this systematic review and meta-analysis were sourced from multiple bibliographic databases. This review followed PRISMA guidelines. The Hazard Ratio (HR) was selected as the effect size metric to independently assess overall survival (OS), disease-free survival (DFS), and prognosis. Subgroup analysis was performed for individual highly represented miRNA. A total of 6843 patients across 50 studies were included in the systematic review and 34 studies were included in the meta-analysis. Studies across 12 countries were assessed, with China representing 36.7% of all included studies. The analysis of the survival endpoints of OS and DFS were conducted separately, with the overall pooled effect size (HR) for each being 1.825 (95% CI 1.527-2.181; < 0.05) and 2.596 (95% CI 1.917-3.515; < 0.05), respectively. Subgroup analysis was conducted for impact of miR-21, 200b, 155, 18a, 34c-5p, 125b, 20a and 375 on OS, and miR-21 and 34a on DFS. The pooled results were found to be statistically significant for both OS and DFS. The meta-analysis indicated that miRNA alterations can account for an 82.5% decrease in OS probability and a 159.6% decrease in DFS probability. These results indicate that miRNAs have potential clinical value as prognostic biomarkers in HNC, with miR-21, 125b, 34c-5p and 18a, in particular, showing great potential as prognostic molecular markers. Further large scale cohort studies focusing on these miRNAs are recommended to verify the clinical utility of these markers individually and/or in combination.
头颈部癌症（HNC）是全球第六大常见癌症类型，每年有超过 30 万人因此死亡。然而，目前还没有标准化的分子标志物来帮助确定 HNC 的预后。本系统评价和荟萃分析的文献来源于多个文献数据库。本综述遵循 PRISMA 指南。风险比（HR）被选为评估总生存率（OS）、无病生存率（DFS）和预后的效应量指标。对个体高代表性 miRNA 进行了亚组分析。共有 50 项研究的 6843 名患者纳入系统评价，34 项研究纳入荟萃分析。评估了来自 12 个国家的研究，其中中国占所有纳入研究的 36.7%。分别对 OS 和 DFS 的生存终点进行了分析，总体合并效应大小（HR）分别为 1.825（95%CI 1.527-2.181；<0.05）和 2.596（95%CI 1.917-3.515；<0.05）。对 miR-21、200b、155、18a、34c-5p、125b、20a 和 375 对 OS 的影响以及 miR-21 和 34a 对 DFS 的影响进行了亚组分析。结果表明，OS 和 DFS 的合并结果均具有统计学意义。荟萃分析表明，miRNA 的改变可导致 OS 概率降低 82.5%，DFS 概率降低 159.6%。这些结果表明，miRNA 具有作为 HNC 预后生物标志物的潜在临床价值，miR-21、125b、34c-5p 和 18a 尤其具有作为预后分子标志物的巨大潜力。建议进一步开展大型队列研究，重点关注这些 miRNA，单独或联合评估这些标志物的临床效用。
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