环状RNA在中国人群肺癌中诊断效能的Meta分析

Diagnostic value of circular RNA in lung cancer in Chinese populations:a Metaanalysis

目的系统评价环状RNA在中国人群肺癌中的综合诊断价值。方法在PubMed、Embase、Cochrane Library、Web of Science、CNKI、CBM、WanFang Data、VIP等数据库检索,检索时限均为建库至2020年3月5日。由两名研究人员按照纳入与排除标准筛选文献和提取数据。利用诊断试验质量评价工具(QUADAS-2)评价纳入研究的偏倚风险。采用Review Manager 5.3、Meta-Disc 1.4和STATA 16.0软件进行Meta分析。结果共纳入9项文献共13个研究,包括686例肺癌患者。Meta分析结果显示,环状RNA诊断肺癌的合并灵敏度为0.74(95%CI:0.70~0.78)、合并特异度为0.79(95%CI:0.73~0.84)、阳性似然比为3.50(95%CI:2.70~4.40)、阴性似然比为0.33(95%CI:0.29~0.38)、诊断OR为10.00(95%CI:8.00~14.00)和曲线下面积(AUC)为0.81(95%CI:0.77~0.84)。亚组分析结果显示,以样本量≤50、环状RNA表达上调、组织为检测基质的环状RNA诊断肺癌的价值均优于样本量>50、环状RNA表达下调和血液。Meta回归分析表明,样本量大小、环状RNA的差异表达和样本类型均是潜在的异质来源。结论环状RNA具有成为诊断中国人群肺癌的新型生物标志物的潜能。

Objective To systematically evaluate the potential diagnostic value of circular RNA(circRNA)for lung cancer in China.Method The relevant literatures were identified in database such as PubMed,Embase,Cochrane Library,Web of Science,CBM,CNKI,WanFang Data and VIP(up to March 5th,2020).Two researchers screened literatures basing on inclusion and exclusion criteria,and extracted data.The risk of bias in studies included in this Meta-analysis was assessed by using the quality assessment of diagnostic accuracy studies(QUADAS-2)tool.Review Manager 5.3,Meta-Disc 1.4 and STATA(version 16.0)software were used to perform Meta-analysis.Result A total of 13 studies were included in 9 literatures,including 686 lung cancer patients.The result of Meta-analysis showed that the pooled sensitivity,speciality,positive likelihood ratios,negative likelihood ratios,and diagnostic OR with their 95%CI were 0.74(95%CI:0.70-0.78),0.79(95%CI:0.73-0.84),3.50(95%CI:2.70-4.40),0.33(95%CI:0.29-0.38),10.00(95%CI:8.00-14.00),with an area under the area under curve(AUC)of 0.81(95%CI:0.77-0.84).The results of subgroup analysis demonstrated that the value of circular RNA with sample size≤50,up-regulation of circular RNA expression,and tissue as the detection matrix for diagnosis of lung cancer was better than that of sample size>50,down-regulation of circular RNA expression and blood.Meta-regression analysis showed that sample size,differential expression of circular RNA,and sample type were all potential sources of heterogeneity.Conclusion Circular RNA might have the potential of being the novel biomarker of diagnosing lung cancer in Chinese populations.