Toraih Eman A, Elshazli Rami M, Trinh Lily N, Hussein Mohammad H, Attia Abdallah A, Ruiz Emmanuelle M L, Zerfaoui Mourad, Fawzy Manal S, Kandil Emad
Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA.
Genetics Unit, Department of Histology and Cell Biology, Suez Canal University, Ismailia 41522, Egypt.
Cancers (Basel). 2021 Aug 26;13(17):4295. doi: 10.3390/cancers13174295.
Circulatory tumor-derived exosomal microRNAs (miRNAs) play key roles in cancer development/progression. We aimed to assess the diagnostic/prognostic value of circulating exosomal miRNA in thyroid cancer (TC). A search in PubMed, Scopus, Web of Science, and Science Direct up to 22 May 2021 was performed. The true/false positive (TP/FP) and true/false negative (TN/FN) rates were extracted from each eligible study to obtain the pooled sensitivity, specificity, positive/negative likelihood ratios (PLR/NLR), diagnostic odds ratio (DOR), and their 95% confidence intervals (95%CIs). The meta-analysis included 12 articles consisting of 1164 Asian patients and 540 controls. All miRNAs were quantified using qRT-PCR assays. The pooled sensitivity was 82% (95%CI = 77-86%), pooled specificity was 76% (95%CI = 71-80%), and pooled DOR was 13.6 (95%CI = 8.8-21.8). The best biomarkers with high sensitivity were miR-16-2-3p (94%), miR-223-5p (91%), miR-130a-3p (90%), and miR182-5p (94%). Similarly, they showed high specificity, in addition to miR-34c-5p. Six panels of two to four exosomal miRNAs showed higher diagnostic values with an area under the curve (AUC) ranging from 0.906 to 0.981. The best discriminative ability to differentiate between cancer and non-cancer individuals was observed for miR-146b-5p + miR-223-5p + miR-182-5p (AUC = 0.981, sensitivity = 93.8% (84.9-98.3), specificity = 92.9% (76.5-99.1)). In conclusion, the expression levels of exosomal miRNAs could predict TC.
循环肿瘤来源的外泌体微小RNA（miRNA）在癌症发展/进展中起关键作用。我们旨在评估循环外泌体miRNA在甲状腺癌（TC）中的诊断/预后价值。截至2021年5月22日，我们在PubMed、Scopus、Web of Science和Science Direct数据库中进行了检索。从每项符合条件的研究中提取真/假阳性（TP/FP）率和真/假阴性（TN/FN）率，以获得合并敏感性、特异性、阳性/阴性似然比（PLR/NLR）、诊断比值比（DOR）及其95%置信区间（95%CI）。荟萃分析纳入了12篇文章，包括1164例亚洲患者和540例对照。所有miRNA均使用qRT-PCR检测进行定量。合并敏感性为82%（95%CI = 77-86%），合并特异性为76%（95%CI = 71-80%），合并DOR为13.6（95%CI = 8.8-21.8）。具有高敏感性的最佳生物标志物为miR-16-2-3p（94%）、miR-223-5p（91%）、miR-130a-3p（90%）和miR182-5p（94%）。同样，除miR-34c-5p外，它们也显示出高特异性。六组由两到四个外泌体miRNA组成的组合显示出更高的诊断价值，曲线下面积（AUC）范围为0.906至0.981。对于miR-146b-5p + miR-223-5p + miR-182-5p，观察到区分癌症和非癌症个体的最佳鉴别能力（AUC = 0.981，敏感性 = 93.8%（84.9-98.3），特异性 = 92.9%（76.5-99.1））。总之，外泌体miRNA的表达水平可预测甲状腺癌。
