Kardoust Parizi Mehdi, Singla Nirmish, Daneshmand Siamak, Heidenreich Axel, Bagrodia Aditya, Margulis Vitaly, Matsukawa Akihiro, Tsuboi Ichiro, Shariat Shahrokh F
Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
World J Urol. 2025 Mar 27;43(1):192. doi: 10.1007/s00345-025-05571-y.
To evaluate the diagnostic efficacy of serum microRNAs in predicting pathologic findings of retroperitoneal lymph node dissection (RPLND) in patients with testicular germ cell tumors (TGCT).
PUBMED, SCOPUS, and Cochrane Library were searched in August 2024 to identify eligible studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines.
Nine studies comprising 603 patients were selected in this review. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of microRNA-371a-3p for predicting viable tumor other than pure teratoma in RPLND specimen were 0.76 (95% CI 0.49-0.90), 0.97 (95% CI 0.81-0.99) and 31.75 (95% CI 9.24-109.10), respectively. The pooled sensitivity for primary and post-chemotherapy RPLND (PC-RPLND), were 0.77 (95% CI 0.47-0.93) and 0.73 (95% CI 0.28-0.95), respectively. The pooled specificity for primary and PC-RPLND were 0.92 (95% CI 0.72-0.98) and 0.99 (95% CI 0.62-1.00), respectively. The pooled DOR for primary and PC-RPLND were 13.86 (95% CI 2.97-64.79) and 64.11 (95% CI 13.09-313.98), respectively. The major limitation is the lack of standardization of miR371 testing.
miR-371a-3p is a relatively sensitive and highly specific marker for predicting viable tumors in RPLND pathologic findings. The DOR was particularly significant for patients who underwent PC-RPLND. While serum microRNAs may be useful in distinguishing viable germ cell tumors from necrosis, fibrosis, and teratomas, their ability to differentiate teratomas from necrosis is limited. Well-designed prospective studies are essential to enhance our understanding of the predictive performance of microRNAs.
评估血清微小RNA在预测睾丸生殖细胞肿瘤（TGCT）患者腹膜后淋巴结清扫术（RPLND）病理结果中的诊断效能。
2024年8月检索了PUBMED、SCOPUS和Cochrane图书馆，根据系统评价和Meta分析的首选报告项目（PRISMA 2020）指南确定符合条件的研究。
本综述纳入了9项研究，共603例患者。微小RNA-371a-3p预测RPLND标本中除纯畸胎瘤外的存活肿瘤的合并敏感性、特异性和诊断比值比（DOR）分别为0.76（95%CI 0.49-0.90）、0.97（95%CI 0.81-0.99）和31.75（95%CI 9.24-109.10）。原发性和化疗后腹膜后淋巴结清扫术（PC-RPLND）的合并敏感性分别为0.77（95%CI 0.47-0.93）和0.73（95%CI 0.28-0.95）。原发性和PC-RPLND的合并特异性分别为0.92（95%CI 0.72-0.98）和0.99（95%CI 0.62-1.00）。原发性和PC-RPLND的合并DOR分别为13.86（95%CI 2.97-64.79）和64.11（95%CI 13.09-313.98）。主要局限性是miR371检测缺乏标准化。
miR-371a-3p是预测RPLND病理结果中存活肿瘤的相对敏感且高度特异的标志物。对于接受PC-RPLND的患者，DOR尤为显著。虽然血清微小RNA可能有助于区分存活的生殖细胞肿瘤与坏死、纤维化和畸胎瘤，但其区分畸胎瘤与坏死的能力有限。精心设计的前瞻性研究对于增强我们对微小RNA预测性能的理解至关重要。
