General Dental Practice, St Helens, UK.
Evid Based Dent. 2022 Mar;23(1):10-11. doi: 10.1038/s41432-022-0247-x. Epub 2022 Mar 25.
Data sources The online databases of Medline, Web of Science, Embase and Cochrane Library were systematically searched to identify articles published (up to October 2021) on the accuracy of microRNAs (miRNAs) in the diagnosis of oral squamous cell carcinoma (OSCC).Study selection Primary research studies involving human participants with the presence of healthy controls and sufficient data for statistical analysis were included. Exclusion criteria included review articles, letters, case reports and non-human trials. Two reviewers independently assessed the studies, and any conflicts were resolved by consulting a third reviewer. From 326 initially identified articles, 20 articles (all case-control studies) were included in the meta-analysis involving 1,106 cases and 732 controls.Data extraction and synthesis Data extracted included sensitivity, specificity, likelihood ratios and diagnostic odds ratios for blood and salivary miRNAs. A combined category of body fluid miRNAs was also synthesised. Heterogeneity between studies was evaluated using Cochran's Q test and I2 statistic. Quality assessment of the studies was performed using the Quality Assessment of Diagnostic Accuracy Studies criteria (QUADAS-2). Meta-analysis was performed based on a random-effects model. A comparison of the diagnostic accuracies between blood and salivary miRNAs was carried out using the summary receiver operator characteristic curve (SUROC) including the area under the curve (AUC). P <0.05 was considered as statistically significant.Results Risk of bias was deemed to be moderate; however, patient selection bias was high due to 15 studies lacking randomisation. Heterogeneity between studies was high. Meta-analysis revealed that for body fluid miRNAs, sensitivity was 0.78 (95% CI: 0.73-0.83), specificity was 0.82 (95% CI: 0.77-0.86), AUC value was 0.87 (95% CI: 0.84-0.90), and positive and negative likelihood ratios were 4.3 (95% CI: 3.4-5.4) and 0.27 (95% CI: 0.22-0.34), respectively. The diagnostic odds ratio was 16 (95% CI: 11-23).Conclusions Body fluid miRNAs may provide moderate accuracy in diagnosing OSCC; however, the significant heterogeneity between studies and the lack of large-scale high-quality studies limits their diagnostic value.
系统检索了 Medline、Web of Science、Embase 和 Cochrane Library 在线数据库，以确定截至 2021 年 10 月发表的关于 microRNAs（miRNAs）在口腔鳞状细胞癌（OSCC）诊断中的准确性的文章。
纳入了涉及有健康对照和有足够统计分析数据的人类参与者的初步研究。排除标准包括综述文章、信件、病例报告和非人类试验。两位审稿人独立评估研究，如有分歧则咨询第三位审稿人。最初确定了 326 篇文章，其中 20 篇（均为病例对照研究）纳入了包含 1106 例病例和 732 例对照的荟萃分析。
提取的数据包括血液和唾液 miRNAs 的敏感性、特异性、似然比和诊断优势比。还综合了体液 miRNAs 的类别。使用 Cochran's Q 检验和 I2 统计量评估研究之间的异质性。使用诊断准确性研究质量评估标准（QUADAS-2）对研究进行质量评估。基于随机效应模型进行荟萃分析。使用包括曲线下面积（AUC）在内的综合接收者操作特征曲线（SUROC）比较血液和唾液 miRNAs 的诊断准确性。P<0.05 被认为具有统计学意义。
偏倚风险被认为是中度的；然而，由于 15 项研究缺乏随机分组，患者选择偏倚较高。研究之间的异质性较高。荟萃分析显示，对于体液 miRNAs，敏感性为 0.78（95%CI：0.73-0.83），特异性为 0.82（95%CI：0.77-0.86），AUC 值为 0.87（95%CI：0.84-0.90），阳性和阴性似然比分别为 4.3（95%CI：3.4-5.4）和 0.27（95%CI：0.22-0.34），诊断优势比为 16（95%CI：11-23）。
体液 miRNAs 可能在诊断 OSCC 方面具有中等准确性；然而，研究之间存在显著的异质性，并且缺乏大规模高质量的研究限制了它们的诊断价值。
