尿路上皮癌相关1基因在膀胱癌中诊断效能的Meta分析

Meta-analysis of overall diagnostic efficacy of urothelial carcinoma associated gene 1 in bladder carcinoma

目的评价长链非编码RNA尿路上皮癌相关1(LncRNA-UCA1)在膀胱癌中的诊断价值。方法检索中英文数据库收集相关文献,采用"诊断性研究的量表评价(QUADAS)"工具评估文献质量;通过随机/固定效应模型合并效应量;进行灵敏度检验和回归分析探讨异质性来源;采用Deek′s漏斗图评估文章发表偏倚。结果共纳入6篇文献,含919例膀胱癌和418例非癌/健康对照。LncRNA-UCA1诊断膀胱癌的合并灵敏度为0.83(95%CI:0.73～0.89),特异度为0.92 (95%CI:0.84～0.96),曲线下面积(AUC)为0.94。亚组分析显示,基于尿液和组织的LncRNA-UCA1检测具有一定的诊断效能。基于人群的分析显示,LncRNAUCA1在非洲人群中AUC数值最高(0.97),亚洲人群次之(AUC=0.94),欧洲人群中AUC仅为0.78。Deek′s漏斗图分析显示研究间不存在发表偏倚。结论 LncRNA-UCA1在膀胱癌中具有较高的诊断效能,有望作为膀胱癌较好的诊断辅助指标之一。

Objective To systematically meta-analyze the overall diagnostic efficacy of long non-coding RNA urothelial carcinoma associated 1 （LncRNA-UCA1） in bladder carcinoma. Methods The online databases were searched for relevant articles.Study quality was assessed using QUADAS checklist.The overall diagnostic parameters were pooled using a random or fixed effects model.Influence analysis and meta-regression analysis were performed to further trace the sources of heterogeneity among studies.Publication bias was judged using Deek′s funnel plot. Results A total of 6 studies comprising 919 patients and 418 paired controls were included.Our analysis showed that LncRNA-UCA1 testing achieved a pooled sensitivity of 0.83 （95% CI ：0.73-0.89） and specificity of 0.92 （95% CI ：0.84-0.96） in confirming bladder carcinoma,with an area under curve （AUC） of 0.94.Subgroup study revealed that both urine- and tissue-based LncRNA-UCA1 testing showed equal diagnostic efficacy.Moreover,the analysis based on ethnicity showed that LncRNA-UCA1 testing yielded the best AUC of 0.97 in African,and the second one was in Asian （AUC=0.94）,whereas the European-based assay only had an AUC of 0.78.Deek′s funnel plot analysis suggested that no significant publication bias existed among studies. Conclusion LncRNA-UCA1 reveals as an immense potential as a novel biomarker to help the diagnosis of bladder carcinoma.