School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, China.
Department of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
Clin Exp Med. 2020 Aug;20(3):339-348. doi: 10.1007/s10238-020-00638-z. Epub 2020 Jun 5.
Exosome-derived long non-coding RNAs (lncRNAs) as novel biomarkers are widely investigated in various cancers, yet results remain controversial. The aim of this meta-analysis was to clarify the diagnostic and prognostic value of exosome-derived lncRNAs in cancer.
PubMed, Web of Science, EMBASE, CNKI, and WanFang online databases were comprehensively searched for eligible studies up to January, 2020. To evaluate the diagnostic effect, sensitivity, specificity, and area under the curve (AUC) were pooled. Threshold effect, subgroup analysis, and meta-regression were applied to explore heterogeneity. Deeks' funnel plot and sensitivity analysis were used to examine publication bias and stability of meta-analysis, respectively. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS) and recurrence free survival (RFS) were calculated to assess the prognostic value.
A total of 29 eligible studies involving 3882 patients were enrolled in the meta-analysis, which included 26 on diagnosis and 11 on prognosis. For diagnosis analysis, the pooled sensitivity, specificity, and AUC were 0.83 (95% CI 0.78-0.87), 0.80 (95% CI 0.75-0.84), and 0.88 (95% CI 0.85-0.91), respectively. Meta-regression revealed that the cancer type acted as the potential source of heterogeneity. Sensitivity analysis and Deeks' funnel plot indicated that results were relatively robust and had no publication bias. For the prognosis analysis, results suggested that overexpression of exosome-derived lncRNAs which upregulated in cancer showed a significant association with poor OS (HR 2.21, 95% CI 1.79-2.71, p < 0.001). Conversely, overexpression of exosome-derived lncRNAs which downregulated in cancer was markedly related to better OS (HR 0.28, 95% CI 0.14-0.55, p < 0.001).
This meta-analysis reveals that exosome-derived lncRNAs might serve as promising diagnostic and prognostic biomarkers for cancer. However, the clinical value of exosome-derived lncRNAs needs to be further confirmed.
外泌体衍生的长链非编码 RNA（lncRNA）作为新型生物标志物在各种癌症中得到了广泛研究，但结果仍存在争议。本荟萃分析旨在阐明外泌体衍生 lncRNA 在癌症中的诊断和预后价值。
全面检索了PubMed、Web of Science、EMBASE、CNKI 和万方在线数据库，以获取截至 2020 年 1 月的合格研究。为了评估诊断效果，汇总了敏感性、特异性和曲线下面积（AUC）。应用阈值效应、亚组分析和荟萃回归来探讨异质性。Deeks 漏斗图和敏感性分析分别用于检查发表偏倚和荟萃分析的稳定性。计算总生存（OS）和无复发生存（RFS）的合并风险比（HR）及其 95%置信区间（CI）以评估预后价值。
共纳入 29 项符合条件的研究，共计 3882 例患者，其中 26 项用于诊断，11 项用于预后。对于诊断分析，汇总的敏感性、特异性和 AUC 分别为 0.83（95%CI 0.78-0.87）、0.80（95%CI 0.75-0.84）和 0.88（95%CI 0.85-0.91）。荟萃回归显示，癌症类型是异质性的潜在来源。敏感性分析和 Deeks 漏斗图表明，结果相对稳健，无发表偏倚。对于预后分析，结果表明，在癌症中上调的外泌体衍生 lncRNA 的高表达与 OS 不良显著相关（HR 2.21，95%CI 1.79-2.71，p<0.001）。相反，在癌症中下调的外泌体衍生 lncRNA 的高表达与 OS 改善显著相关（HR 0.28，95%CI 0.14-0.55，p<0.001）。
本荟萃分析表明，外泌体衍生 lncRNA 可能成为癌症有前途的诊断和预后生物标志物。然而，外泌体衍生 lncRNA 的临床价值仍需进一步证实。
