He Jimin, Jiang Yao, Liu Liang, Zuo Zhihua, Zeng Chun
Department of Neurosurgery, Suining Central Hospital, Suining, China.
Department of Clinical Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Front Neurol. 2021 Feb 1;11:610163. doi: 10.3389/fneur.2020.610163. eCollection 2020.
Currently, circulating microRNAs (miRNAs) are considered to be non-invasive diagnostic biomarkers in a broad range of tumors. Nevertheless, so far, miRNAs have not been fully applied to the clinic for routine screening in glioma patients. Thus, our goal is to evaluate the diagnostic performance of circulating miRNAs for gliomas via a meta-analysis. The present study is registered on the PROSPERO website, with the number CRD42020195883. Literature retrieval was implemented in the PubMed, Embase, and Web of Science databases using the established search strategy. We pooled the sensitivity, specificity, and its 95% confidence intervals (CIs) for the included studies using the Stata 14.0 software. In addition, the heterogeneity between studies was assessed via the statistics and values calculated by a Chi-square test. A bivariate random effects model was selected due to significant heterogeneity. Specifically, for exploring the factors influencing the heterogeneity, we implemented subgroup and meta-regression analyses. Ultimately, a Deek's funnel plot asymmetry test was used to estimate the potential publication bias. A total of 18 articles covering 24 studies were included, containing 2,170 glioma patients and 1,456 healthy participants. The overall pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were 0.84 (95%CI: 0.79-0.87), 0.84 (95%CI: 0.80-0.88), 5.3 (95%CI: 4.1-6.8), 0.19 (95%CI: 0.15-0.25), 27 (95%CI: 18-41), and 0.91 (95%CI: 0.88-0.93), respectively. Additionally, the findings revealed that serum miRNAs and miRNA panels presented superior diagnostic performance. Thus, circulating miRNAs have the potential to serve as diagnostic biomarkers for gliomas, but need to be verified via a large pool of prospective studies. Additionally, specific miRNAs still need to be elucidated in the diagnosis of a glioma, especially in the early screening stage. The findings may provide diagnostic and therapeutic strategies for the glioma population.
目前，循环微RNA（miRNA）被认为是多种肿瘤的非侵入性诊断生物标志物。然而，到目前为止，miRNA尚未完全应用于胶质瘤患者的临床常规筛查。因此，我们的目标是通过荟萃分析评估循环miRNA对胶质瘤的诊断性能。本研究已在PROSPERO网站注册，注册号为CRD42020195883。使用既定的检索策略在PubMed、Embase和Web of Science数据库中进行文献检索。我们使用Stata 14.0软件汇总纳入研究的敏感性、特异性及其95%置信区间（CI）。此外，通过卡方检验计算的统计量和 值评估研究之间的异质性。由于存在显著异质性，选择了双变量随机效应模型。具体而言，为了探索影响异质性的因素，我们进行了亚组分析和荟萃回归分析。最终，使用Deek漏斗图不对称性检验来估计潜在的发表偏倚。共纳入18篇文章，涵盖24项研究，包括2170例胶质瘤患者和1456名健康参与者。总体汇总敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）和曲线下面积（AUC）分别为0.84（95%CI：0.79 - 0.87）、0.84（95%CI：0.80 - 0.88）、5.3（95%CI：4.1 - 6.8）、0.19（95%CI：0.15 - 0.25）、27（95%CI：18 - 41）和0.91（95%CI：0.88 - 0.93）。此外，研究结果表明血清miRNA和miRNA组合具有更好的诊断性能。因此，循环miRNA有潜力作为胶质瘤的诊断生物标志物，但需要通过大量前瞻性研究进行验证。此外，在胶质瘤诊断中，尤其是早期筛查阶段，仍需要阐明特定的miRNA。这些发现可能为胶质瘤患者提供诊断和治疗策略。
