Su Quanxin, Wu Hao, Zhang Ziyi, Lu Chao, Zhang Lifeng, Zuo Li
Department of Urology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.
Department of Graduate School, Dalian Medical University, Dalian, China.
Front Oncol. 2021 Aug 19;11:719863. doi: 10.3389/fonc.2021.719863. eCollection 2021.
As a result of the inconsistency between reports, a meta-analysis was designed to appraise the clinical implications of long non-coding RNAs (lncRNAs) in exosomes for the diagnosis of bladder cancer.
The PubMed, EMBASE, and Cochrane library databases were searched to identify the relevant literature on lncRNAs in exosomes for bladder cancer diagnosis from database inception to May 2021. The literature was screened according to the inclusion and exclusion criteria, and the Quality Assessment of Diagnostic Accuracy Studies-2 entry tool was applied to evaluate the quality of the literature, and the sources of heterogeneity were explored using meta-regression and subgroup analysis. Stata 14.0 and RevMan 5.3 software were used for statistical analysis.
A total of 23 studies described in 10 articles were included, with a total of 1883 patients with bladder cancer and 1721 patients in the non-cancerous control group. The exosome-derived lncRNAs performed better in the diagnosis of bladder cancer with a pooled sensitivity of 0.74 (95% CI, 0.69-0.77), specificity of 0.76 (95% CI, 0.72-0.80), and area under the curve of 0.83. The heterogeneity between studies was partly as a result of differences in specimen type, number of lncRNAs, lncRNA expression form, and reference gene type. Subgroup analysis showed that the detection efficacy based on the combination of multiple lncRNAs (0.86, 95% CI, 0.82-0.88) was higher than that based on a single lncRNA (0.81, 95% CI, 0.78-0.85), and exosomal lncRNAs with blood as the detection sample had a high diagnostic efficacy (0.86, 95% CI, 0.82-0.86).
Exosome-derived lncRNAs hold great promise as non-invasive diagnostic biomarkers of bladder cancer. However, their clinical value needs to be examined in further comprehensive prospective studies.
由于各报告之间存在不一致性，因此设计了一项荟萃分析，以评估外泌体中长链非编码RNA（lncRNAs）在膀胱癌诊断中的临床意义。
检索了PubMed、EMBASE和Cochrane图书馆数据库，以确定从数据库建立至2021年5月关于外泌体中lncRNAs用于膀胱癌诊断的相关文献。根据纳入和排除标准对文献进行筛选，并应用诊断准确性研究质量评估-2条目工具评估文献质量，使用荟萃回归和亚组分析探讨异质性来源。采用Stata 14.0和RevMan 5.3软件进行统计分析。
共纳入10篇文章中描述的23项研究，其中共有1883例膀胱癌患者和1721例非癌对照组患者。外泌体来源的lncRNAs在膀胱癌诊断中表现更佳，合并敏感度为0.74（95%CI，0.69-0.77），特异度为0.76（95%CI，0.72-0.80），曲线下面积为0.83。研究之间的异质性部分归因于样本类型、lncRNAs数量、lncRNA表达形式和参照基因类型的差异。亚组分析显示，基于多种lncRNAs组合的检测效能（0.86，95%CI，0.82-0.88）高于基于单一lncRNA的检测效能（0.81，95%CI，0.78-0.85），以血液作为检测样本的外泌体lncRNAs具有较高的诊断效能（0.86，95%CI，0.82-0.86）。
外泌体来源的lncRNAs作为膀胱癌的非侵入性诊断生物标志物具有很大潜力。然而，其临床价值需要在进一步全面的前瞻性研究中进行检验。
