Diagnostic value of circular RNAs as promising hematological biomarkers in acute myeloid leukemia: A systematic review and meta-analysis.

Despite significant advancements in the diagnosis and treatment of acute myeloid leukemia (AML), patients still face poor diagnosis with unsatisfactory survival, so it is imperative to explore novel diagnostic biomarkers to improve early detection and treatment outcomes. Thus, here, the potential role of circular RNAs (circRNAs) in AML diagnosis is reviewed. PubMed, Scopus, WOS, ProQuest databases, and Google Scholar search engines were searched for studies published through March 2023. The results were assessed using the modified method of GRADE assessment. The sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC) were combined to investigate the diagnostic role of circRNAs in AML. The number of studies included in this systematic review and meta-analysis was 18. For the diagnostic value of circRNAs in AML, the pooled SEN, SPE, PLR, and NLR were 0.85 (95% confidence interval [CI]: 0.80-0.89), 0.85 (95% CI: 0.82-0.88), 5.74 (95% CI: 4.49-7.33), and 0.18 (95% CI: 0.13-0.24), respectively. Furthermore, the pooled DOR and AUC were 32.71 (95% CI: 20.09-53.24) and 0.91 (95% CI: 0.88-0.93), respectively. Furthermore, through subgroup analysis, it is better to have a sample size above 120 and a control/patient ratio above 50%. In addition, Deek's funnel plot demonstrated nonconsiderable publication bias ( = 0.65). Finally, according to the GRADE assessment for diagnostic tests, the certainty of evidence regarding sensitivity and specificity was moderate. Our systematic review and meta-analysis suggest the analysis of circRNAs expression as promising and valuable biomarkers related to the diagnosis of AML and also can be helpful in the diagnosis of AML patients as a noninvasive and low-cost method.