循环microRNA-21对癌症诊断价值的Meta分析

Diagnostic Value of Circulating MicroRNA- 21 for Cancer: A Meta-Analysis

目的评价循环徽RNA21（miR-21）对不同类型癌症的诊断价值。方法检索PubMed、Medline、Embase、中国生物医学文献数据库（CBMdisc）、中文期刊全文数据库（CNKI）、中国科技期刊数据库（VIP）、万方数据库等，检索时间为1990年1月至2014年11月，收集关于循环miR-21诊断癌症的相关文献。依据诊断试验文献质量评价标准（QUADAS-2）对纳入文献进行质量评价。采用Metadisc1．4和STATA12．0软件进行Meta分析，绘制合并受试者工作特征（SROC）曲线，计算曲线下面积（AUC），并进行敏感性分析及发表偏倚的评估。结果纳入符合要求的文献26篇，包含31个研究，共计3421例研究对象。纳入文献存在非阈值效应引起的异质性，采用随机效应模型计算循环miR-21诊断癌症的合并灵敏度和特异度分别为0．78（95％C10．76～0．80）和0．79（95％C10．77～0．82），其诊断比值比（DOR）为16．92（95％C111．91—24．04），SROC—AUC为0．875，标准误（SE）为0．015。结论循环miR-21对癌症诊断效能属中等，尚不能确定其诊断癌症具有高度准确性，但可作为重要的参考指标之一，仍需要更多的大样本高质量的临床试验加以验证。

Objective To evaluate the diagnostic value of circulating microRNA-21 （ miR-21 ） for differ- ent cancers. Methods PubMed, Medline, Embase, CBMdisc, CNKI, VIP and Wanfang Chinese Periodical Database were searched to identify and retrieve relevant studies on circulating miR-21 in diagnosis of cancer from Jan. 1990 to Nov. 2014. QUADAS-2 was used for quality evaluation of the literature. Meta-analysis was performed by employing MetsDisc 1.4 and STATA 12. 0 software. Summary receiver operating characteristic （ SROC ） curve was made and the area under curve （AUC） was calculated. Finally, sensitivity analysis and publication bias assessment were performed. Results Altogether 26 literatures including 31 studies and 3421 cases were included. The literature had non-threshold effect caused heterogeneity. Combined sensitivity and specificity of circulating miR-21 test for the diagnosis of cancer were 0. 78 （95 % CI 0. 76-0. 80 ） ,0. 79 （95% CI 0. 77-0. 82） calculated by random effect model. Its diagnostic odds ratio （DOR） was 16.92 （95% CI 11.91-24. 04 ）, the SROC-AUC curve was 0. 875, and the standard error （SE） was 0. 015. Conclusion The circulating miR-21 has moderate efficiency in identifying cancer,while it can＇t be concluded to have high accuracy, but it can be used as one of the important reference indexes, and larger high quality clinical studies are needed to verify the findings in the future.