piRNAs表达失调作为癌症潜在诊断标志物的价值:一项系统评价和Meta分析

Dysregulated expression of piRNAs serve as diagnostic markers in cancers:a systematic review and meta-analysis

目的Piwi相互作用RNA(piRNA)作为新型生物标志物已被广泛用于各种癌症诊断中。本研究旨在系统评估piRNA对癌症的诊断准确性并分析可能导致研究异质性的原因,以便为临床实践提供参考。方法计算机检索PubMed、Web of Science、Embase、Cochrane library、CNKI、WanFang Data、VIP和CBM数据库,搜集piRNA诊断癌症的相关研究,检索时限均从建库至2023年4月。应用诊断性试验质量评价工具QUADAS-2评估纳入研究的方法学质量,使用Stata 17.0软件进行统计分析。结果共纳入17篇文献(涉及46项研究),包含4956名癌症患者和3759名对照人群。各研究报告的敏感性的范围为21%~100%,特异性的范围为50%~100%。Meta分析结果显示:piRNA诊断癌症的合并敏感度为0.74[95%CI(0.68,0.79)],特异度为0.79[95%CI(0.75,0.82)],PLR为3.49[95%CI(3.01,4.05)],NLR为0.33[95%CI(0.27,0.40)],DOR为11[95%CI(8,14)],AUC为0.83[95%CI(0.80,0.86)],表明piRNA对癌症诊断具有较高的准确性。结论piRNA可作为诊断癌症的可靠的生物标志物,具有良好的灵敏度和特异性。然而,缺乏标准化和结果可重复性仍然是piRNA诊断在临床应用的最大问题。

Objective PIWI-interacting RNA(piRNA)has emerged as a promising tool for cancer diagnosis.The aim of this meta-analysis was to summarize the existing literature and systematically assess the diagnostic performance of piRNAs in cancer,as well as identify potential sources of inter-study heterogeneity to provide information for clinical practice.Methods The PubMed,Web of Science,Embase,Cochrane library,CNKI,WanFang,VIP and CBM databases were electronically searched to collect diagnostic trials of piRNAs in cancer from inception to April 2023.The methodological quality of the included studies was assessed using the QUADAS-2 tool,and statistical analysis was conducted using Stata 17.0 software.Results A total of 17 papers(46 studies)involving 4956 cancer patients and 3759 controls were included.The range of sensitivity was 21%-100%and the range of specificity was 50%-100%.Meta-analysis showed that the combined sensitivity of piRNA for the diagnosis of cancer was 0.74(95%CI 0.68 to 0.79),the specificity was 0.79(95%CI 0.75 to 0.82),the PLR was 3.49(95%CI 3.01 to 4.05),the NLR was 0.33(95%CI 0.27 to 0.40),DOR of 11(95%CI 8 to 14),and AUC of 0.83(95%CI 0.80 to 0.86),indicating that piRNA had high accuracy for cancer diagnosis.Conclusion piRNA shows promise as a reliable biomarker for cancer diagnosis,with good sensitivity and specificity.However,the lack of standardization and result reproducibility remain significant challenges in the clinical application of piRNA-based diagnostics.