General Practice Department, Beijing Tsinghua Changgung Hospital, Changping District, Beijing, China.
Medicine (Baltimore). 2023 Nov 17;102(46):e35857. doi: 10.1097/MD.0000000000035857.
Lung cancer is the leading cause of death worldwide, and its diagnosis remains a significant challenge. Identifying effective methods to differentiate benign from malignant lung nodules is of paramount importance. This meta-analysis aimed to evaluate the clinical utility of circulating microRNAs (miRNAs) for the differential diagnosis of benign and malignant lung nodules.
This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted across 4 electronic databases, without any temporal restrictions. The inclusion and exclusion criteria were strictly applied to assess the clinical applications of circulating miRNAs. A robust and transparent quality assessment was performed using the quality assessment of diagnostic accuracy studies-2 tool, and rigorous statistical analyses were conducted to synthesize the various diagnostic measures.
In the meta-analysis of 11 studies, quality assessment of diagnostic accuracy studies-2 assessment revealed < 5% high-risk methodologies, ensuring robustness. Sensitivity and Specificity were consolidated at 0.83 (95% confidence interval [CI]: 0.72-0.90) and 0.81 (95% CI: 0.73-0.88), respectively. The positive likelihood ratio and negative likelihood ratio were 4.45 (95% CI: 3.03-6.54) and 0.21 (95% CI: 0.12-0.35), respectively. The diagnostic odds ratio was 21.31 (95% CI: 10.25-44.30) and area under the receiver operating characteristic curve was 0.89 (95% CI: 0.86-0.91). Subgroup analysis highlighted significant variations in diagnostic accuracy by ethnicity and miRNA source, with non-Asian populations and serum-based tests showing higher diagnostic accuracy.
This meta-analysis demonstrated that circulating miRNAs hold substantial diagnostic value in distinguishing between benign and malignant lung nodules.
肺癌是全球范围内导致死亡的主要原因，其诊断仍然是一个重大挑战。确定区分良性和恶性肺结节的有效方法至关重要。本荟萃分析旨在评估循环 microRNAs（miRNAs）在区分良性和恶性肺结节中的临床应用价值。
本研究遵循系统评价和荟萃分析的首选报告项目指南。全面检索了 4 个电子数据库，没有时间限制。严格应用纳入和排除标准来评估循环 miRNAs 的临床应用。使用诊断准确性研究质量评估工具-2 对研究质量进行了严格的评估，并进行了严格的统计分析，以综合各种诊断措施。
在 11 项研究的荟萃分析中，诊断准确性研究质量评估工具-2 评估发现<5%的高风险方法，确保了稳健性。灵敏度和特异性分别为 0.83（95%置信区间[CI]：0.72-0.90）和 0.81（95% CI：0.73-0.88）。阳性似然比和阴性似然比分别为 4.45（95% CI：3.03-6.54）和 0.21（95% CI：0.12-0.35）。诊断优势比为 21.31（95% CI：10.25-44.30），受试者工作特征曲线下面积为 0.89（95% CI：0.86-0.91）。亚组分析表明，种族和 miRNA 来源对诊断准确性有显著影响，非亚洲人群和基于血清的检测显示出更高的诊断准确性。
本荟萃分析表明，循环 miRNAs 在区分良性和恶性肺结节方面具有重要的诊断价值。
