痰microRNA检测对肺癌诊断价值的Meta分析

DIAGNOSTIC ACCURACY OF SPUTUM MICRORNAS FOR LUNG CANCER:A META-ANALYSIS

目的目前有多项研究提示痰microRNA可作为肺癌的诊断标记物,但研究结论尚不一致,此次研究拟系统评价检测痰microRNA对肺癌的综合诊断价值。方法在PubMed、Embase、CNKI、万方、维普等数据库检索利用检测痰microRNA诊断肺癌的文献。QUADAS评分评价纳入文献的质量。MetaDisc 1.4软件计算合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比及其95%可信区间。绘制综合受试者工作特征曲线并计算曲线下面积。结果共有9篇文献1 372例研究对象纳入本次Meta分析,检测痰microRNA对肺癌的综合诊断价值分别为:敏感度为0.73,特异度为0.88,阳性似然比为6.24,阴性似然比为0.30,诊断比值比为21.04。综合受试者工作特征曲线下面积为0.88,Q值为0.81。结论检测痰microRNA对肺癌的诊断具有一定的临床价值,具有高度的特异度。痰microRNA检测结果的解读应综合参考患者的临床症状和其他检验结果。

Objective To investigate the overall accuracy of sputum microRNAs test in the diagnosis of lung cancer. Methods A systematic review was conducted in PubMed, Embase, China Hospital Knowledge Database, Wanfang and Weipu to identify relevant studies on evaluation of sputum microRNAs in the diagnosis of lung cancer. The methodological quality of each study was assessed by QUADAS. Statistical analysis was performed by employing Meta- Disc 1.4 software to calculate pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and its 95% CI. Summary receiver operating characteristic curve was made and the area under the curve was calculated. Results Nine papers with 1372 subjects met the inclusion criteria for present analysis. The summary estimates for sputum microR- NAs in the diagnosis of lung cancer were： sensitivity 0.73, specificity 0.88, positive likelihood ratio 6.24, negative likelihood ratio 0.30, diagnostic odds ratio 21.04, and the area under the curve was 0.88 with a Q value of 0.81. Conclusions Sputum microRNAs plays a role in the diagnosis of lung cancer with high specificity. The results of sputum microRNAs tests should be interpreted in parallel with clinical symptoms and other test results.