长链非编码RNA作为肝细胞癌诊断新型血清标志物的meta分析

A meta-analysis of long non-coding RNAs as novel serum biomarkers for the diagnosis of hepatocellular carcinoma

背景与目的:长链非编码RNA(long non-coding RNA,lnc RNA)是一类具有巨大前景的新型肿瘤标志物。该研究旨在疏理lnc RNA用于诊断肝细胞癌(hepatocellular carcinoma,HCC)的研究概况。方法:使用计算机检索Pub Med、EMbase、Cochrane Library、CBM、CNKI及万方数据库,检索时限均从建库至2017年2月。纳入的研究通过诊断准确性研究质量评价工具(Quality Assessment of Diagnostic Accuracy Studies2,QUADAS-2)进行质量评价。采用随机效应模型合并分析灵敏度、特异度、阳性似然率和阴性似然率。通过受试者工作特征(receiver operating characteristic,ROC)曲线和曲线下面积(area under curve,AUC)估计整体检验效能。数据采用Stata 12.0和Meta-Disc 1.4软件进行统计分析。结果:最终共纳入13个研究,其中,HCC患者1 296例,健康对照者1 304人。整体lnc RNA诊断HCC的灵敏度、特异度、阳性似然率和阴性似然率分别为83%(95%CI:81%~85%)、82%(95%CI:80%~84%)、5.32(95%CI:3.37~8.42)和0.21(95%CI:0.15~50.28),对应的AUC为0.91。结论:Lnc RNA对于HCC具有高度的诊断价值,并且其表达可作为确诊HCC的辅助生物标志物。

Background and purpose： Long non-coding RNAs（lnc RNA） are outstanding as novel cancer biomarkers with great prospects. Hence, we aimed to summarize the overall diagnostic assessment of lnc RNAs for hepatocellular carcinoma（HCC）. Methods： A systematic search was performed in Pub Med, EMbase, Cochrane Library, CBM, CNKI and Wanfang database from establishment of the database to February 2017. The quality of included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2（QUADAS-2） checklist. The pooled sensitivity, specificity, positive likelihood ratio（LR） and negative LR were analyzed using random effect model. The overall test efficacy was estimated using the summary receiver operating characteristic（ROC） curve and the area under the curve（AUC）. Statistical analysis was conducted using Stata 12.0 and Meta-Disc 1.4 software. Results： A total of 13 studies involving 1296 patients with hepatocellular carcinoma and 1304 healthy controls were finally included. For overall lnc RNA, the pooled sensitivity, specificity, positive LR and negative LR to predict HCC patients were 83%（95%CI： 81%-85%）, 82%（95%CI： 80%-84%）, 5.32（95%CI： 3.37-8.42） and 0.21（95%CI： 0.15-50.28）, respectively, corresponding to an AUC of 0.91. Conclusion： Lnc RNA have high diagnostic value for HCC, and their expressions can be used as auxiliary biomarkers in confirming HCC.