四类体液microRNAs对OSCC诊断价值的系统评价

A systematic review of diagnostic value of four types of humoral microRNAs for OSCC

目的:系统评价四类体液(血浆、唾液、血清及全血)microRNAs对于口腔鳞癌(oral squanous cell carcinoma OSCC)的诊断价值。方法:搜索维普、万方等主要数据库,收集使用体液microRNAs诊断OSCC的诊断性试验。用QUADAS-2工具对所有收集到的文献进行偏倚风险评估。将纳入文献按不同体液样本类型分为4组。用Meta-Disc1.4经Spearman相关系数及Cochran-Q检验来判断阈值效应与非阈值效应的有无;用Reveman5.3分析四组中各项合并统计量;用Stata13.0作Deek’s漏斗图确定发表偏倚的有无。结果:最终纳入11篇文献,含19项体液microRNAs。血浆组合并敏感度、合并特异度和SROC曲线的AUC分别为0.87(95%CI:0.83~0.90)、0.85(95%CI:0.81~0.89)和0.93;血清组合并敏感度、合并特异度和SROC曲线的AUC分别为0.7(95%CI:0.72~0.85)、0.78(95%CI:0.70~0.85)和0.87;唾液组合并敏感度、合并特异度和SROC曲线的AUC分别为0.77(95%CI:0.71~0.83)、0.78(95%CI:0.70~0.85)和0.84;全血组合并敏感度、合并特异度和SROC曲线的AUC分别为0.73(95%CI:0.66~0.80)、0.81(95%CI:0.72~0.88)和0.82。结论:在四类体液microRNAs样本中,血浆组的合并敏感度、合并特异度等各项诊断参数合并量均居首位,对于OSCC表现出更高的综合诊断能力。血清组和唾液组的诊断效能接近,分居二、三位,全血组对于OSCC的诊断效能最低。

Objective:To explore the diagnostic value of four types of humoral microRNAs(plasma,saliva,se⁃rum,and whole blood)for oral squamous cell carcinoma(OSCC).Methods:Databases were searched for diagnos⁃tic trials in which OSCC was diagnosed using humoral microRNAs;these trials were collected based on strict inclu⁃sion and exclusion criteria.The QUADAS-2 tool was used to assess the risk of bias in all the collected literature.The included literature was divided into four groups according to the types of humoral samples.Meta-Disc1.4 was used to determine the presence of threshold effect and non-threshold effect based on Spearman correlation coeffi⁃cient and Cochran-Q test.Pooled statistics in the four groups were analyzed with Reveman5.3.Stata13.0 was used to draw a Deek’s funnel plot to determine the presence of publication bias.Results:Eleven pieces of literature(in⁃cluding 19 humoral microRNAs)which had a relatively low risk of bias were included.The pooled sensitivity,pooled specificity,and area under the summary receiver operating characteristic curve were 0.87(95%confidence interval[CI]:0.83~0.90),0.85(95%CI:0.81~0.89),and 0.93,respectively,for the plasma group,0.7(95%CI:10.72~0.85),0.78(95%CI:0.70~0.85),and 0.87,respectively,for the serum group,0.77(95%CI:0.71~0.83),0.78(95%CI:0.70~0.85),and 0.84,respectively,for the saliva group,and 0.73(95%CI:0.66~0.80),0.81(95%CI:0.72~0.88),0.82,respectively,for the whole blood group.Conclusion:Among the four types of humoral microRNA samples,the plasma group ranks first in pooled diagnostic parameters such as pooled sensitivity and pooled specificity,showing higher overall diagnostic performance for OSCC.The diagnostic performance of the serum group and saliva group are similar,ranking second and third,respectively;the whole blood group has the poorest diagnostic performance for OSCC.