Li Yue, Zhu Longbiao, Zhu Chenjing, Chen Yan, Yu Hui, Zhu Hangju, Yin Ping, Liu Mengyu, Li Yang, Li Huixin, Gong Zhen, Han Jing
Jiangsu Cancer Centre, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The AffiliatedCancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of The Sixth Dental Division, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Discov Oncol. 2024 May 27;15(1):189. doi: 10.1007/s12672-024-01028-7.
Cervical cancer is a prevalent malignancy of the female reproductive system. Cervical intraepithelial neoplasia (CIN) is a precursor lesion for CC. Various studies have examined circulating microRNAs (miRNAs) as potential early diagnostic markers for CC and CIN. However, the findings have been inconclusive. Therefore, it is necessary to evaluate the diagnostic accuracy and identify potential sources of variability among these studies.
The PubMed, Cochrane Library, Embase, and Web of Science databases were searched to identify relevant literature. Then, Stata 14.0 was utilized to calculate summary estimates for diagnostic parameters, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic (ROC). To scrutinize the heterogeneity, the Cochran-Q test and I statistic were utilized. As significant heterogeneity was observed, the random effects model was chosen. To explore potential sources of the heterogeneity, subgroup and regression analyses were conducted.
We analysed 12 articles reporting on 24 studies involving 1817 patients and 1731 healthy controls. The pooled sensitivity was 0.77 (95% CI 0.73-0.81), the specificity was 0.81 (95% CI 0.73-0.86), the PLR was 3.99 (95% CI 2.81-5.65), the NLR was 0.28 (95% CI 0.23-0.35), the DOR was 14.18 (95% CI 8.47-23.73), and the area under the curve (AUC) was 0.85 (95% CI 0.81-0.87). Subgroup analysis revealed that multiple miRNAs can improve diagnostic performance; the pooled sensitivity of multiple miRNAs was 0.78 (95% CI 0.68-0.86), the specificity was 0.85 (95% CI 0.78-0.90), and the AUC was 0.89 (95% CI 0.86-0.91).
This study suggested that circulating microRNAs may be biomarkers for early CC diagnosis.
宫颈癌是女性生殖系统中一种常见的恶性肿瘤。宫颈上皮内瘤变（CIN）是宫颈癌的前驱病变。多项研究已将循环微小RNA（miRNA）作为宫颈癌和CIN潜在的早期诊断标志物进行了检测。然而，研究结果尚无定论。因此，有必要评估这些研究中的诊断准确性并确定潜在的变异来源。
检索PubMed、Cochrane图书馆、Embase和Web of Science数据库以识别相关文献。然后，使用Stata 14.0计算诊断参数的汇总估计值，包括敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）以及汇总接受者操作特征曲线（ROC）下的面积。为了仔细检查异质性，使用了Cochran-Q检验和I统计量。由于观察到显著的异质性，选择了随机效应模型。为了探索异质性的潜在来源，进行了亚组分析和回归分析。
我们分析了12篇文章，这些文章报道了涉及1817例患者和1731例健康对照的24项研究。汇总敏感性为0.77（95%CI 0.73 - 0.81），特异性为0.81（95%CI 0.73 - 0.86），PLR为3.99（95%CI 2.81 - 5.65），NLR为0.28（95%CI 0.23 - 0.35），DOR为14.18（95%CI 8.47 - 23.73），曲线下面积（AUC）为0.85（95%CI 0.81 - 0.87）。亚组分析显示，多种miRNA可提高诊断性能；多种miRNA的汇总敏感性为0.78（95%CI 0.68 - 0.86），特异性为0.85（95%CI 0.78 - 0.90），AUC为0.89（95%CI 0.86 - 0.91）。
本研究表明，循环微小RNA可能是宫颈癌早期诊断的生物标志物。
