Xu Yi, Li Changxia, Cheng Lifang, Wang Shaoheng, Wu Yuqing, Li Shiyang, Liu Mingqiang, Tao Xiaohua
Dermatology Hospital of Jiangxi Province, Jiangxi Provincial Clinical Research Center For Skin Diseases, Candidate Branch of National Clinical Research Center for Skin Diseases, Dermatology Institute of Jiangxi Province, The Affiliated Dermatology Hospital of Nanchang University, Nanchang, China.
Third Clinical Medical College, Nanchang University, Nanchang, China.
Front Oncol. 2025 Jan 13;14:1488040. doi: 10.3389/fonc.2024.1488040. eCollection 2024.
Cervical cancer (CC) is a highly prevalent malignancy of the reproductive system. This study aimed to methodically assess the function of circular RNAs (circRNAs) as possible indicators of CC, with a specific emphasis on their usefulness in the identification, prediction, and correlation with clinicopathological elements.
A comprehensive literature search was conducted using databases such as PubMed, Cochrane Library, Web of Science, Embase, and the China National Knowledge Infrastructure (CNKI). The latest data were extracted on May 3, 2024. The diagnostic potential of circRNA expression was evaluated using a range of metrics including sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). The importance of circRNAs was further evaluated in terms of clinical relevance, pathological features, and prognostic value using pooled odds ratios (ORs) and hazard ratios (HRs).
The meta-analysis included 27 studies, which were categorised based on diagnostic applications (n=3), clinicopathological correlations (n=15), and prognostic evaluations (n=23). Elevated expression levels of oncogenic circRNAs were significantly associated with poor clinical indicators, including tumour size (odds ratio [OR] = 0.425, 95% confidence interval [CI]: 0.267-0.676), International Federation of Gynaecology and Obstetrics (FIGO) stage (OR = 0.315, 95% CI: 0.224-0.443), and lymph node metastasis (OR = 2.975, 95% CI: 1.816-4.872). This upregulation of oncogenic circRNA was also identified as a predictor of worse survival outcomes, with a hazard ratio (HR) of 2.13 (95% CI: 1.73-2.62, < 0.001). The downregulation of circRNAs with tumour-suppressor properties was similarly associated with poor clinical parameters, such as tumour size (OR = 0.310, 95% CI: 0.102-0.941), FIGO stage (OR = 0.231, 95% CI: 0.101-0.527), and lymph node metastasis (OR = 2.430, 95% CI: 1.156-5.110), and was indicative of a worsened prognosis (HR = 2.20, 95% CI: 1.03-4.70, = 0.042). In terms of diagnostic value, the pooled sensitivity, specificity, and area under the curve (AUC) were calculated to be 0.85, 0.83, and 0.91, respectively.
The results of our meta-analysis indicate that circRNAs have the potential to serve as promising biomarkers for CC diagnosis, prognosis, and clinicopathology.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024544997.
宫颈癌（CC）是生殖系统中一种高度常见的恶性肿瘤。本研究旨在系统评估环状RNA（circRNA）作为宫颈癌可能指标的功能，特别强调其在识别、预测以及与临床病理因素相关性方面的实用性。
使用PubMed、Cochrane图书馆、Web of Science、Embase和中国知网（CNKI）等数据库进行全面的文献检索。于2024年5月3日提取最新数据。使用包括灵敏度、特异性和受试者工作特征曲线下面积（AUC）等一系列指标评估circRNA表达的诊断潜力。使用合并比值比（OR）和风险比（HR），从临床相关性、病理特征和预后价值方面进一步评估circRNA的重要性。
荟萃分析纳入了27项研究，这些研究根据诊断应用（n = 3）、临床病理相关性（n = 15）和预后评估（n = 23）进行分类。致癌性circRNA表达水平升高与不良临床指标显著相关，包括肿瘤大小（比值比[OR] = 0.425，95%置信区间[CI]：0.267 - 0.676）、国际妇产科联盟（FIGO）分期（OR = 0.315，95% CI：0.224 - 0.443）和淋巴结转移（OR = 2.975，95% CI：1.816 - 4.872）。致癌性circRNA的这种上调也被确定为生存结果较差的预测指标，风险比（HR）为2.13（95% CI：1.73 - 2.62，P < 0.001）。具有肿瘤抑制特性的circRNA下调同样与不良临床参数相关，如肿瘤大小（OR = 0.310，95% CI：0.102 - 0.941）、FIGO分期（OR = 0.231，95% CI：0.101 - 0.527）和淋巴结转移（OR = 2.430，95% CI：1.156 - 5.110），并提示预后恶化（HR = 2.20，95% CI：1.03 - 4.70，P = 0.042）。在诊断价值方面，合并灵敏度、特异性和曲线下面积（AUC）分别计算为0.85、0.83和0.91。
我们的荟萃分析结果表明，circRNA有潜力作为宫颈癌诊断、预后和临床病理学的有前景的生物标志物。
