miRNAs对胰腺癌诊断价值的Meta分析

Diagnostic value of miRNAs for pancreatic cancer: a meta-analysis

目的探讨mi RNAs对胰腺癌(pancreatic cancer)的诊断价值。方法计算机检索Pub Med、Scopus、Web of Science、CBM、CNKI、Wan Fang Data和VIP数据库,搜集mi RNAs诊断胰腺癌的诊断性试验,检索时限均从建库至2015年12月31日。由2位研究者独立筛选文献、提取资料,并采用QUADAS-2工具评价纳入研究的偏倚风险后,采用Meta Di Sc 1.4及Stata 12.0软件进行Meta分析。结果共纳入40篇文献,109个研究。mi RNAs诊断胰腺癌的Sen_(合并)=0.81[95%CI(0.80,0.82)]、Spe_(合并)=0.77[95%CI(0.75,0.78)]、+LR_(合并)=3.15[95%CI(2.78,3.58)]、–LR_(合并)=0.27[95%CI(0.24,0.31)]、DOR_(合并)=13.58[95%CI(10.89,16.94)]、AUC=0.86[95%CI(0.84,0.88)]。诊断准确性白种人优于亚洲人(AUC=0.89 vs.0.84),联合mi RNAs优于单一mi RNA(AUC=0.91 vs.0.84)。结论现有证据表明,mi RNAs对胰腺癌具有一定诊断价值,尤其是联合mi RNAs诊断。但受纳入研究质量的限制,上述结论仍需开展高质量的研究予以验证。

Objective To explore the diagnostic value of miRNAs for pancreatic cancer. Methods PubMed, Scopus, Web of Science, CBM, CNKI, WanFang Data and VIP databases were retrieved from inception to December 31st 2015, to collect diagnostic accuracy studies about miRNAs for pancreatic cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by using the QUADAS-2 tool. Then metaanalysis was performed using MetaDiSc 1.4 and Stata 12.0 softwares. Results A total of 40 articles involving 109 studies were included. The results of meta-analysis showed that the pooled Sen, Spe, ＋LR, -LR and DOR were 0.81 （95%CI 0.80 to 0.82）, 0.77 （95%CI 0.75 to 0.78）, 3.15 （95%CI 2.78 to 3.58）, 0.27 （95%CI 0.24 to 0.31） and 13.58 （95%CI 10.89 to 16.94）, respectively. The AUC of SROC was 0.86 （95%CI 0.84 to 0.88）. Subgroups analysis showed that： as to diagnostic accuracy, Caucasian was superior to Asian （AUC=0.89 vs. 0.84）; multiple-miRNAs profiling-based assays was superior to single miRNA assays （AUC=0.91 vs. 0.84）. Conclusion Current evidence suggests that miRNA has potential diagnostic value for pancreatic cancer, particularly using multiple miRNAs. Due to limited quality of the included studies, more high quality studies are needed to verify the above conclusion.