Mukhopadhyay D, Cocco P, Orrù S, Cherchi R, De Matteis S
Molecular and Translational Medicine, Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Cagliari, Italy.
Centre for Occupational and Environmental Health, Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, United Kingdom.
Pulmonology. 2025 Dec 31;31(1):2416792. doi: 10.1016/j.pulmoe.2024.02.002. Epub 2024 Oct 24.
Asbestos is still the leading cause of occupational cancer mortality worldwide. Asbestos-related lung cancer (LC) and malignant pleural mesothelioma (MPM) prognosis is still poor especially at advanced stage, so early diagnosis biomarkers are needed. MicroRNAs (miRNAs) have been proposed as potential early diagnostic biomarkers of asbestos-related LC and MPM.
To evaluate the role of miRNAs as diagnostic and prognostic biomarkers of asbestos-related LC and MPM by performing a literature systematic review and meta-analysis.
MEDLINE, EMBASE via Ovid, PUBMED and Cochrane library databases were systematically searched up to April 2023 to identify relevant articles. A grey literature search was also conducted using the Google Scholar platform. MeSH and free text terms for 'asbestos', 'occupational exposure', 'lung cancer', 'mesothelioma' and 'miRNAs' were used to search the literature. Our systematic review protocol was registered in the PROSPERO database. Study quality was assessed via the Newcastle-Ottawa Scale.
From the search, 331 articles were retrieved, and, after applying our selection criteria, and exclusion of one study for poor quality, 27 studies were included in the review. Most of the studies were hospital-based case-control, conducted in Europe, and evaluated MPM among men only. MiRNAs expression was measured mainly in plasma or serum. MiR-126, miR-132-3p, and miR-103a-3p were the most promising diagnostic biomarkers for MPM, and we estimated a pooled area under the curve (AUC) of 85 %, 73 %, and 50 %, respectively. In relation to MPM prognosis, miR-197‑3p resulted associated with increased survival time. MiR-126, alone and combined with miR-222, was confirmed associated also to LC diagnosis, together with miR-1254 and miR-574-5p; no miRNA was found associated to LC prognosis.
Based on our systematic literature review there is suggestive evidence that the expression of specific miRNAs in the blood serum or plasma are associated with asbestos-related LC and MPM diagnosis and prognosis. Further large longitudinal studies are urgently needed to validate these findings and elucidate the underlying mechanisms given the potential important implications for patients' survival.
石棉仍是全球职业性癌症死亡的主要原因。与石棉相关的肺癌（LC）和恶性胸膜间皮瘤（MPM）的预后仍然很差，尤其是在晚期，因此需要早期诊断生物标志物。微小RNA（miRNA）已被提议作为石棉相关LC和MPM的潜在早期诊断生物标志物。
通过进行文献系统评价和荟萃分析，评估miRNA作为石棉相关LC和MPM的诊断和预后生物标志物的作用。
截至2023年4月，对MEDLINE、通过Ovid的EMBASE、PUBMED和Cochrane图书馆数据库进行系统检索，以识别相关文章。还使用谷歌学术平台进行了灰色文献检索。使用“石棉”、“职业暴露”、“肺癌”、“间皮瘤”和“miRNA”的医学主题词（MeSH）和自由文本词进行文献检索。我们的系统评价方案已在PROSPERO数据库中注册。通过纽卡斯尔-渥太华量表评估研究质量。
通过检索，共检索到331篇文章，在应用我们的选择标准并排除一项质量较差的研究后，27项研究被纳入评价。大多数研究是以医院为基础的病例对照研究，在欧洲进行，且仅评估男性中的MPM。miRNA表达主要在血浆或血清中测量。MiR-126、miR-132-3p和miR-103a-3p是MPM最有前景的诊断生物标志物，我们估计其曲线下面积（AUC）合并值分别为85%、73%和50%。关于MPM的预后，miR-197-3p与生存时间延长相关。MiR-126单独以及与miR-222联合，与miR-1254和miR-574-5p一起，也被证实与LC诊断相关；未发现与LC预后相关的miRNA。
基于我们的系统文献评价，有提示性证据表明血清或血浆中特定miRNA的表达与石棉相关LC和MPM的诊断及预后相关。鉴于对患者生存可能具有的重要意义，迫切需要进一步开展大型纵向研究以验证这些发现并阐明潜在机制。
