Chen Bi, Zhang Ruo Nan, Fan Xingxing, Wang Jue, Xu Cong, An Bo, Wang Qiao, Wang Jing, Leung Elaine Lai-Han, Sui Xinbing, Wu Qibiao
Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau, P.R. China.
State Key Laboratory of Quality Research in Chinese Medicines, (Macau University of Science and Technology), Taipa, Macau, P. R. China.
J Cancer. 2020 Jul 11;11(18):5518-5526. doi: 10.7150/jca.46358. eCollection 2020.
Histopathological diagnosis remains the gold standard for the diagnosis of cancer, including colorectal cancer, but it is infeasible when tumor tissue is not available. With the recognition of long non-coding RNAs (lncRNAs), the expression of lncRNAs in serum or tissue samples has been reported as a diagnosis method for some cancers, however, the diagnostic value of lncRNAs for colorectal cancer remains unclear. A systematic review and meta-analysis were conducted. Eligible studies were identified through a comprehensive literature search in PubMed, PubMed Central, Web of Science, Embase, and Cochrane Library (up to May 05, 2020) according to the selection criteria. Meta-DiSc, Review Manager and STATA were used to analyze the association between lncRNAs expression and the diagnosis of colorectal cancer. Fifteen studies that analyzed the expression of 15 lncRNAs in 1434 CRC patients were included. The summary area under the curve (AUC) of lncRNA for the diagnosis efficacy between patients with and without CRC was estimated to be 0.8629, corresponding to a weighted sensitivity of 0.75 (95% CI: 0.72 - 0.77), specificity of 0.80 (95%CI: 0.78 - 0.82). Subgroup analysis illustrated that the AUC of blood-based detection of lncRNA showed 0.8820, pooled DOR: 18.57, while tissue-based analysis showed 0.8203, pooled DOR: 10.47. Blood-based tests were then divided into two categories, plasma-based and serum-based lncRNA testing. Results revealed that the AUC of serum-based detection was 0.9077, pooled DOR: 26.64, and plasma-based detection was 0.5000, pooled DOR: 11.80. This meta-analysis indicates that the aberrantly expressed lncRNAs might serve as potential diagnostic biomarkers for CRC patients and blood-based lncRNA analysis is of higher diagnostic accuracy than tissue-based testing. Moreover, serum-based lncRNA testing achieved higher diagnostic efficacy than plasma-based analysis.
组织病理学诊断仍是包括结直肠癌在内的癌症诊断的金标准，但当无法获取肿瘤组织时则不可行。随着长链非编码RNA（lncRNA）的发现，血清或组织样本中lncRNA的表达已被报道可作为某些癌症的诊断方法，然而，lncRNA对结直肠癌的诊断价值仍不明确。我们进行了一项系统评价和荟萃分析。根据选择标准，通过在PubMed、PubMed Central、Web of Science、Embase和Cochrane图书馆（截至2020年5月5日）进行全面的文献检索，确定符合条件的研究。使用Meta-DiSc、Review Manager和STATA分析lncRNA表达与结直肠癌诊断之间的关联。纳入了15项分析1434例结直肠癌患者中15种lncRNA表达的研究。lncRNA用于结直肠癌患者与非患者诊断效能的汇总曲线下面积（AUC）估计为0.8629，相应的加权灵敏度为0.75（95%CI：0.72 - 0.77），特异性为0.80（95%CI：0.78 - 0.82）。亚组分析表明，基于血液检测lncRNA的AUC为0.8820，合并比值比（DOR）为18.57，而基于组织分析的AUC为0.8203，合并DOR为10.47。基于血液的检测随后分为两类，即基于血浆的lncRNA检测和基于血清的lncRNA检测。结果显示，基于血清检测的AUC为0.9077，合并DOR为26.64，基于血浆检测的AUC为0.5000，合并DOR为11.80。这项荟萃分析表明，异常表达的lncRNA可能作为结直肠癌患者潜在的诊断生物标志物，且基于血液的lncRNA分析比基于组织的检测具有更高的诊断准确性。此外，基于血清的lncRNA检测比基于血浆的分析具有更高的诊断效能。
