循环miRNAs检测对肾细胞癌诊断价值的Meta分析

Value of circulating miRNAs in the diagnosis of renal cell carcinoma:a Meta analysis

目的评估检测循环miRNAs表达水平对肾细胞癌临床诊断的价值。方法全面检索Pub Med、Medline、Embase、Web of Science、中国知网和万方等数据库,获取检测循环miRNAs表达水平对肾细胞癌诊断价值的相关文献。应用诊断准确性研究的质量评价工具QUADAS-2评估文献质量。提取数据后采用Meta-disc 1.4软件进行分析。异质性采用Cochran-Q检验和I2检验分析。采用Stata 12.0软件绘制漏斗图,评价纳入文献的发表性偏倚。结果有16篇文献共计1 461例肾细胞癌患者和1 021例非肾细胞癌患者纳入本次Meta分析。循环miRNA诊断肾细胞癌的合并灵敏度(SENSE)为0.79(95%CI0.77-0.82)、合并特异度(SPE)为0.73(95%CI 0.70-0.75)、合并阳性似然比(PLR)为3.66(95%CI 2.72-4.91)、合并阴性似然比(NLR)为0.27(95%CI 0.23-0.32)、合并诊断优势比(DOR)为15.16(95%CI 10.05-22.87)。合并受试者工作特征曲线下面积(AUC)为0.866。结论循环miRNAs的检测可用作肾细胞癌的早期诊断和筛查指标。

Objective To evaluate the value of circulating miRNAs detection in the diagnosis of renal cell carcinoma.Methods PubMed, Medline, Embase, Web of Science, CNKI and Wanfang database were searched for studies about circulating miRNAs detection in the diagnosis of renal cell carcinoma. The qualities of documents were evaluated with QUADAS-2 score system. Software Meta-disc 1.4 was used to analyze data. Heterogeneity was analyzed by Cochran- Q test and I 2 test. The Stata 12.0 was used to test the publication bias.Results A total of 16 documents met the inclusion and exclusion criteria involving a total of 1 461 cases of renal cell carcinoma and 1 021 cases of non-renal cell carcinoma. The sensitivity and specificity of circulating miRNAs detection for renal cell carcinoma were 0.79（95%CI 0.77-0.82） and 0.73（95%CI 0.70-0.75）,respectively. The positive likelihood ratio and negative likelihood ratio were 3.66（95%CI 2.72-4.91） and 0.27（95%CI 0.23-0.32）, respectively. The diagnostic odds ratio was 15.16（95%CI 10.05-22.87）. The area under curve of the summary receiver operating characteristic（sROC） was 0.866（SE=0.014 8）.Conclusion The detection of circulating miRNAs shows a high specificity and sensitivity in the diagnosis of renal cell carcinoma and it can be used in the early clinical screening and diagnosis of renal cell carcinoma.