Department of Thyroid and Breast Surgery, Hebei General Hospital Affiliated to North China University of Science and Technology, Shijiazhuang 050051, Hebei Province, China.
Department of Thyroid and Breast Surgery, Hebei General Hospital Affiliated to Hebei Medicine University, Shijiazhuang 050051, Hebei Province, China.
Pathol Res Pract. 2022 Aug;236:153871. doi: 10.1016/j.prp.2022.153871. Epub 2022 Apr 2.
An increasing number of studies have reported circular RNAs (circRNAs) as new potential diagnostic and prognostic biomarkers for thyroid cancer. However, the overall predictive value of circRNAs for thyroid cancer remains unclear. Therefore, we performed a comprehensive meta-analysis to investigate the predictive value of circRNAs in the diagnosis, prognosis and clinicopathological features of thyroid cancer (TC).
PubMed, Embase, Cochrane library and Web of science were searched systematically. The search time limit was from the establishment of the database to October 2021. We used the subject words combined with free words for the search. Furthermore, we used Review Manager 5.3 and Meta-Disc1.4 for relevant data analysis, and Stata 13.1 for sensitivity analysis and publication bias test. The combined sensitivity and specificity were used to evaluate the diagnostic value of circRNAs. The hazard ratio (HR) and its 95% confidence interval (95%CI) were used for statistical analysis of the prognosis of TC. The clinical characteristics were analyzed with Odds Ratio (OR) and its 95% CI. P = 0.05 for all analysis, Q test and I analysis were used for heterogeneity evaluation, I ≤ 50% and Q test P > 0.1, indicated the lack of heterogeneity.
A total of 26 eligible studies including 18 on clinicopathological studies, 7 on prognostic and 6 diagnostic studies were enrolled in our meta-analysis. A total of 1911 patients with TC were included. For the clinicopathological and prognostic value, the results showed that a high expression of circRNAs was correlated with poor clinical parameters, such as the tumor size [OR = 2.79, 95%CI (1.88, 4.13)], extra-glandular metastasis (ETE) [OR = 0.74, 95%CI (0.45, 1.53),P = 0.24], TNM staging [OR = 3.82, 95%CI (2.86, 5.10)], lymph node metastasis (LNM) [OR = 3.88, 95% (2.90, 5.19)], tumor focality [OR = 31.87, 95%CI (1.05, 3.31)] and poor overall survival (OS)[ HR = 1.97, 95%CI (1.37, 2.83)]. For the diagnostic value, the sensitivity, specificity and Area Under Curve (AUC) of the combined group were 0.83 [95%CI (0.77-0.87)], 0.77 [95%CI (0.71-0.82)] and 0.91 respectively. CONCLUSIONS：: CircRNAs have a potential diagnostic value for TC. Meanwhile, an elevated expression of circRNAs has been linked to a poor OS in TC patients, and it also associates with poor prognosis of thyroid cancer patients. The expression of circRNAs is also correlated with certain clinical characteristics, suggesting that it may have important clinical significance.
越来越多的研究表明环状 RNA（circRNAs）是甲状腺癌新的潜在诊断和预后生物标志物。然而，circRNAs 对甲状腺癌的总体预测价值仍不清楚。因此，我们进行了一项综合荟萃分析，以探讨 circRNAs 在甲状腺癌（TC）的诊断、预后和临床病理特征中的预测价值。
系统检索了 PubMed、Embase、Cochrane 图书馆和 Web of Science。检索时间限制为从数据库建立到 2021 年 10 月。我们使用主题词结合自由词进行搜索。此外，我们使用 Review Manager 5.3 和 Meta-Disc1.4 进行相关数据分析，使用 Stata 13.1 进行敏感性分析和发表偏倚检验。联合敏感性和特异性用于评估 circRNAs 的诊断价值。风险比（HR）及其 95%置信区间（95%CI）用于 TC 预后的统计学分析。比值比（OR）及其 95%CI 用于分析临床特征。所有分析的 P 值均为 0.05，使用 Q 检验和 I 检验进行异质性评估，I≤50%且 Q 检验 P＞0.1 表示无异质性。
共有 26 项符合条件的研究纳入荟萃分析，其中 18 项为临床病理研究，7 项为预后研究，6 项为诊断研究。共纳入 1911 例 TC 患者。对于临床病理和预后价值，结果显示 circRNAs 高表达与肿瘤大小较大[OR=2.79，95%CI（1.88，4.13）]、腺体外转移（ETE）[OR=0.74，95%CI（0.45，1.53），P=0.24]、TNM 分期[OR=3.82，95%CI（2.86，5.10）]、淋巴结转移（LNM）[OR=3.88，95%CI（2.90，5.19）]、肿瘤局灶性[OR=31.87，95%CI（1.05，3.31）]和总生存期（OS）不良[HR=1.97，95%CI（1.37，2.83）]相关。对于诊断价值，联合组的敏感性、特异性和曲线下面积（AUC）分别为 0.83[95%CI（0.77-0.87）]、0.77[95%CI（0.71-0.82）]和 0.91。
circRNAs 对 TC 具有潜在的诊断价值。同时，circRNAs 的高表达与 TC 患者的 OS 不良相关，也与甲状腺癌患者的预后不良相关。circRNAs 的表达与某些临床特征相关，表明其可能具有重要的临床意义。
