Sabarimurugan Shanthi, Kumarasamy Chellan, Royam Madhav Madurantakam, Samiappan Suja, Jayaraj Rama
Theranostics, GenesisCare, Perth, WA, Australia.
University of Adelaide, North Terrace Campus, Adelaide, SA 5005, Australia.
Cancer Manag Res. 2020 Feb 5;12:819-839. doi: 10.2147/CMAR.S200687. eCollection 2020.
T-cell acute lymphoblastic leukemia (T-ALL) affects lymphoid cells. Previous studies have reported that miRNAs play a significant role in T-ALL prognosis and have the potential to function as biomarkers in T-ALL. Therefore, this systematic review and meta-analysis study was designed to evaluate the overall prognostic impact of miRNAs in T-ALL patients.
Eligible studies published between Jan 2010 and April 2018 were retrieved from online bibliographic databases based on multiple keywords to generate search strings. Meta-analysis was performed using the outcome measure, Hazard Ratio (HR). A survival analysis of all studies was conducted and a subsequent forest plot was generated to evaluate the pooled effect size, across all T-ALL patients. Subgroup analysis was conducted based on demographic characteristics and commonly represented miRNAs among the included studies.
A total of 17 studies were included for systematic review, among which 16 studies were eligible for meta-analysis, which, in total discussed 32 different miRNAs. The mean effect size of HR value was 0.929 (CI 0.878-0984), which indicates a decrease in risk of death by 7.1%. The analysis was based on the random effects model with the heterogeneity measure index (I) being 84.92%. The pooled effect size (HR) of upregulated and downregulated miRNA expressions on survival outcome in the T-ALL patient was 0.787 (CI 0.732-0.845) and 1.225 (CI 1.110-1.344) respectively. The subgroup analysis was performed based on demographic characteristics (age, gender, lactate dehydrogenase, WBC count) and expression of miR221 and miR46a.
Our systematic review and meta-analysis findings suggest that the overall miRNA expression is potentially associated with a decreased likelihood of death in T-ALL patients. Although our findings are inconclusive, the results point toward miRNA expression allowing for prognostic evaluation of T-ALL patients.
T细胞急性淋巴细胞白血病（T-ALL）影响淋巴细胞。既往研究报道，微小RNA（miRNA）在T-ALL预后中起重要作用，并有潜力作为T-ALL的生物标志物。因此，本系统评价和荟萃分析旨在评估miRNA对T-ALL患者总体预后的影响。
基于多个关键词检索2010年1月至2018年4月间发表的符合条件的研究，以生成检索词。采用风险比（HR）作为结局指标进行荟萃分析。对所有研究进行生存分析，并生成森林图以评估所有T-ALL患者的合并效应量。根据纳入研究中的人口统计学特征和常见的miRNA进行亚组分析。
共纳入17项研究进行系统评价，其中16项研究符合荟萃分析条件，共讨论了32种不同的miRNA。HR值的平均效应量为0.929（95%CI 0.878-0.984），表明死亡风险降低了7.1%。分析基于随机效应模型，异质性测量指标（I²）为84.92%。T-ALL患者中miRNA表达上调和下调对生存结局的合并效应量（HR）分别为0.787（95%CI 0.732-0.845）和1.225（95%CI 1.110-1.344）。根据人口统计学特征（年龄、性别、乳酸脱氢酶、白细胞计数）以及miR221和miR46a的表达进行亚组分析。
我们的系统评价和荟萃分析结果表明，总体miRNA表达可能与T-ALL患者死亡可能性降低有关。虽然我们的研究结果尚无定论，但结果表明miRNA表达可用于T-ALL患者的预后评估。
