Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, Urology Unit, SS Annunziata Hospital, Chieti, Italy.
Department of Urology, Campus Biomedico University of Rome, Rome, Italy.
Diagnosis (Berl). 2021 Oct 22;9(2):157-165. doi: 10.1515/dx-2021-0080.
We provide a systematic literature review on tissue miRNAs in patients with RCC to evaluate and summarize their usefulness as prognostic markers. We undertook a systematic search for articles in English using the PubMed-Medline database from January 2010 to December 2020. Studies were identified and selected according to the PRISMA criteria and the PICO methodology. The population consisted of RCC patients undergoing nephrectomy and the main outcome of interest was recurrence-free survival (RFS). Only studies providing hazard ratios (HRs) from multivariate or univariate analyzes with corresponding 95% confidence intervals (CI) and/or area under the curve (AUC) were considered.
All nine included studies (1,541 patients) analyzed the relationship between tissue miRNA expression levels (up or downregulated) and RFS. Some of these found that the methylation status of miR-9-1, miR-9-3 and miR-124 was associated with a high risk of relapse. Moreover, miR-200b overexpression was associated with OS. MiR-210 overexpression indicated a shorter OS than those who were miR-210 negative. Finally, patients with high miR-125b expression had shorter cancer-specific survival (CSS) than those with low expression; similarly, patients with low miR-126 expression also had shorter CSS time.
Several studies tested the usefulness of specific miRNAs to predict RCC recurrence. Some of them showed a fair accuracy and strong relationship between specific miRNA over or under-expression and survival outcomes. However, results from these studies are preliminary and miRNAs use in routine clinical practice is still far to come.
我们对接受肾切除术的 RCC 患者的组织 miRNAs 进行了系统的文献回顾,以评估和总结它们作为预后标志物的有用性。我们使用 PubMed-Medline 数据库从 2010 年 1 月至 2020 年 12 月进行了系统的英文文献检索。根据 PRISMA 标准和 PICO 方法学确定并选择了研究。研究人群包括接受肾切除术的 RCC 患者,主要观察终点是无复发生存率 (RFS)。仅考虑提供多变量或单变量分析的危险比 (HR) 及其相应的 95%置信区间 (CI) 和/或曲线下面积 (AUC) 的研究。
所有纳入的 9 项研究(1541 例患者)分析了组织 miRNA 表达水平(上调或下调)与 RFS 之间的关系。其中一些研究发现,miR-9-1、miR-9-3 和 miR-124 的甲基化状态与复发风险较高有关。此外,miR-200b 过表达与 OS 相关。miR-210 过表达的患者 OS 短于 miR-210 阴性患者。最后,高表达 miR-125b 的患者癌症特异性生存率 (CSS) 短于低表达患者;同样,miR-126 低表达的患者 CSS 时间也较短。
一些研究测试了特定 miRNAs 预测 RCC 复发的有用性。其中一些研究显示出相当的准确性,以及特定 miRNA 的过表达或低表达与生存结果之间的强关系。然而,这些研究的结果是初步的,miRNAs 在常规临床实践中的应用还远未实现。