长链非编码RNA在乳腺癌中诊断效能的Meta分析研究

Meta-analysis of the overall diagnostic efficacy of long-noncoding RNAs in breast cancer

目的 Meta分析评价长链非编码RNA(lncRNA)在乳腺癌(breast cancer,BC)中的综合诊断效能。方法制定纳入标准,系统性检索在线数据库收集相关文献,对符合纳入标准的研究通过"诊断性研究的量表评价(QUADAS)"工具评估文献质量;通过双变量Meta分析模型合并诊断的效应量,并绘制综合受试者工作曲线(SROC);通过敏感性分析、Meta回归分析探讨异质性来源,采用Deek’s漏斗图评估发表偏移。结果共纳入符合标准的文献7篇含7种lncRNA;SROC分析显示,lncRNA诊断乳腺癌的合并灵敏度(SEN)为0.75(95%CI:0.72~0.78),特异度(SPE)为0.80(95%CI:0.77~0.83),曲线下面积(AUC)为0.85。亚组分析显示,基于血浆的lncRNA检测诊断效能优于血清(AUC:0.86 vs 0.84);此外,单项lncRNA检测显示,lncRNA-HOTAIR在乳腺癌诊断中的AUC达0.86,高于lncRNA-MALAT1(AUC=0.81)和-H19(AUC=0.80)。Deek’s漏斗图分析提示不存在发表偏移(P=0.063)。结论 LncRNA表达分析在BC中具有较高的诊断效能,可作为BC较好的辅助诊断指标。

Objective To meta-analyze the overall diagnostic efficacy of long-noncoding RNAs（lncRNAs） in breast cancer（BC）. Methods According to the predefined inclusion criteria,relevant studies were searched and obtained through the online available databases. Study quality of the included studies was assessed by the Quality Assessment of Diagnosis Accuracy Studies（QUADAS） criteria. The pooled effect sizes were synthesized and the summary receiver operator characteristic（SROC） curve was plotted using a bivariate meta-analysis model. Sensitivity analysis and meta-regression test were undertaken to identify the potential causes of study heterogeneity. Publication bias was judged using Deek＇s funnel plot asymmetry test. Results A total of 9 studies were identified covering 7 kinds of lncRNAs. The SROC displayed that the pooled sensitivity and specificity of lncRNA profiling for BC diagnosis were 0.75（95%CI：0.72-0.78） and 0.80（95%CI：0.77-0.83）,respectively,corresponding to an AUC（area under curve） of 0.85. Stratified analyses revealed that the plasma-based lncRNA profiling achieved an efficacy better than that serum-based analysis（AUC：0.86 vs 0.84）. Moreover,single lncRNA testing showed that lncRNA-HOTAIR harbored an AUC of 0.86 better than lncRNA-MALAT1（AUC=0.81） and-H19（AUC=0.80） in diagnosing BC. Deeks＇ funnel plot asymmetry test manifested no clear publication bias among studies. Conclusion LncRNAs testing reveal promising diagnostic efficacy in the identification of BC and therefore might be popularized as auxiliary biomarkers for BC detection.