Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced non-small cell lung cancer： a meta-analysis

Objective： To evaluate the clinical efficacy of Shenqi Fuzheng injection combined with gemcitabine plus cisplatin（GP） in the treatment of advanced non-small cell lung cancer （NSCLC）. Methods： we performed a systematicsearch in the electronic databases such as Cochrane Library, Pubmed, Embase, Chinese Journal Full-text Database,Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Full-text Database andWanfang Database up to 30 January 2017. Randomized controlled trials （RCT） of Shenqi Fuzheng Injectioncombined with GP chemotherapy in the treatment of advanced NSCLC were searched, and all the RCTs wereconducted on methodological quality assessment. Data extraction and data analysis were according to standards ofCochrane systematic review. Results： Eight trials were included including a total of 701 patients. Meta-analysisresults： Shenqi Fuzheng injection combined with GP chemotherapy could significantly improve the functionalstatus of patients with NSCLC （OR = 3.44, 95% CI [2.26, 5.25], P 〈 0.0001） and clinical treatment efficacy （OR =（OR = 0.31, 95%CI [0.20, 0.47], P 〈 0.0001. The rate of leukopenia （OR = .31, 95%CI [0.20,0.47], P 〈 0.0001）,thrombocytopenia （OR = 0.58, 95%CI [0.37, 0.91], P = 0.020）, hemoglobin decline （（OR = 0.31, 95%CI [0.16,0.59], P = 0.0004） and incidence of gastrointestinal reactions （OR = 0.58,P 〈 0.05） could be reduced. Conclusion：Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced NSCLC obtainedsignificantly clinical efficacy. The quality of the literature incorporated is low, the conclusion requires high-qualityresearch to further prove.

Can statins reduce risk of lung cancer,especially among elderly people? A meta-analysis

Objective： As the most common cause of cancer mortality throughout the world, lung cancer has drawn people＇s attention on how to reduce the risk with chemopreventive ways. Many epidemiological studies have shown inconsistent effects of statins on lung cancer, but some observational studies have showed that statins had protective effect on lung cancer among elderly people. So we preformed this meta-analysis to find whether statins were chemopreventive. Methods： We searched MEDLINE, EMBASE and Web of Science databases from inception to September, 2013. A total of 23 studies were selected, including 15 observational studies and 8 randomized controlled trials （RCTs）. Both fixed and random-effects models were used to calculate pooled estimates in primary and sensitivity analyses. We used Q and 12 statistics to assess statistical heterogeneity, and evaluated publication bias by Begg＇s test and Egger＇s test. Results： No association between statins and lung cancer risk was identified either in the meta-analysis among RCTs [relative risk （RR）： 0.95, 95% confidence interval （95% CI）： 0.85-1.06] or observational studies （RR： 0.89, 95% CI： 0.77-1.04）. We also selected 6 observational studies that all researched on elderly people. The result of meta-analysis showed that there was still no protective effect between statins and lung cancer among elderly people （RR： 1.03, 95% CI： 0.96-1.11）. Conclusions： Our results did not support a protective effect of statins on the overall lung cancer risk and the lung cancer risk among elderly people. More well-designed RCTs are needed to enhance our understanding of the chemopreventive effect of statins on lung cancer.

DNA Repair Gene Polymorphisms in the Nucleotide Excision Repair Pathway and Lung Cancer Risk: A Meta-analysis

Objective： A number of studies have reported the association of ＂XPA＂, ＂XPC＂, ＂XPD/ERCC2＂ gene polymorphisms with lung cancer risk. However, the results were conflict. To clarify the impact of polymorphisms of ＂XPA＂, ＂XPC＂, ＂XPD/ERCC2＂, on lung cancer risk, a meta-analysis was performed in this study. Methods： The electronic databases PubMed and Embase were retrieved for studies included in this meta-analysis by ＂XPA＂, ＂XPC＂, ＂XPD/ERCC2＂, ＂lung＂, ＂cancer/neoplasm/tumor/carcinoma＂, ＂polymorphism＂ （An upper date limit of October, 31, 2009）. A meta-analysis was performed to evaluate the relationship among XPA, XPC and XPD polymorphism and lung cancer risks. Results： A total of 31 publications retrieved from Pubmed and Embase included in this study. XPC A939C CC genotype increased lung cancer risk in total population （recessive genetic model： OR=1.23, 95% CI：1.05-1.44; homozygote comparison： OR=1.21,95%CI：1.02-1.43and CC vs. CA contrast： OR=1.25,95%CI：1.06-1.48）, except in Asians. XPD A751C, 751C allele and CC genotype also increased lung cancer risk in total population and in Caucasians （recessive genetic model： Total population： OR=1.20, 95%CI：1.07-1.35）. No significant correlation was found between XPD A751C and lung cancer risk in Asians and African Americans. XPD G312A AA genotype increased lung cancer risk in total population, in Asians and Caucasians（recessive genetic model： Total population： OR=1.20, 95%CI： 1.06-1.36）. No significant association was found between XPA G23A, XPC C499T, XPD C156A and lung cancer risk. Conclusion： Our results suggest that the polymorphisms in XPC and XPD involve in lung cancer risks. XPA polymorphisms is less related to lung cancer risk.

Efficacy and safety of Kang’ai injection adjunct with TP chemotherapy for the treatment of non-small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials

Background:Combination therapy with traditional Chinese medicine and chemotherapy was proposed as a therapeutic strategy for non-small cell lung cancer patients.Therefore,we performed a systematic review and metaanalysis of randomized controlled trials to assess effects of this combination therapy on non-small cell lung cancer.To evaluate the efficacy and safety of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the treatment of non-small cell lung cancer.Methods:A randomized controlled study of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the databases of China National Knowledge Infrastructure Database,WanFang Database,VIP Database,Sino-Med Database,PUBMED,EMBASE and Cochrane library was searched by computer.The literatures published from the database establishment to July 1,2020 were included in the search scope.After 2 evaluators independently evaluated and cross checked the quality of the study,Revman 5.3 was used to meta analyze the clinical effect of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy on patients with non-small cell lung cancer.Results:A total of 1,370 lung cancer patients were included in 20 RCTs.The results of meta-analysis showed that there were significant differences between the 2 groups in clinical efficacy(RR=1.32,95%CI(1.20,1.44)),quality of life(RR=1.44,95%CI(1.32,1.57)),immune function(MD=0.53,95%CI(0.23–0.83)),adverse reactions(RR=0.49,95%CI(0.41,0.58)).Conclusion:The Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy is effective and safe in the treatment of non-small cell lung cancer,and has great prospects for further development.However,the quality of evidence was very low-to-moderate.Considering the poor quality of evidence,we are not very confident in the results.We look forward to more research and update results in the future and improve the evidence quality.

Meta analysis of XRCC3 Thr241Met polymorphism and lung cancer susceptibility of populations in East Asia

Objective:To assess the relation between XRCC3 Thr241Met polymorphism and lung cancer susceptibility of populations in East Asia.Methods:Related studies of XRCC3 Thr24lMet polymorphism and lung cancer susceptibility of populations in East Asia were collected through searching the Pubmed,Embase Library,SPRINGER.CNKI and CSSCI.Results:According to the entry criteria,there were 8 case-control studies in the assessing system and there were 6 321study cases,including 3 215 patients with lung cancer and 3 106 cases without cancers.Meta analysis results showed the combined OR value of the ratio of genotype Thr/Met+Met/Met and Thr/Thr was 1.03(95%CI:0.89-1.20)(P>0.05).Conclusions:XRCC3 Thr241Met polymorphism may not related to lung cancer susceptibility of populations in East Asia.Allele 241Met did not increase the risk of lung cancer.

A Meta-analysis Reveals Prognostic Role of Programmed Death Ligand-1 in Asian Patients with Non-small Cell Lung Cancer

Accumulating studies explored the clinicopathologic and prognostic value of programmed death ligand-1（PD-L1） in non-small cell lung cancer（NSCLC）, but the results were controversial. We therefore conducted a meta-analysis to evaluate the predictive role of PD-L1 in NSCLC patients. We systematically collected relevant studies from Pub Med, Embase, Web of Science and China National Knowledge Infrastructure. The pooled hazard ratios（HRs） with 95% confidence intervals（CIs） for overall survival（OS）, and odd ratios（ORs） with 95% CIs for clinicopathologic factors were calculated. A total of 15 studies involving 3605 patients were included in this meta-analysis. The results showed no prognostic role of PD-L1 in the whole patients（HR=1.60, 95% CI： 0.88–2.89, P=0.123）. Subgroup analysis showed that PD-L1 was associated with decreased OS in Asian patients（HR=2.00, 95% CI： 1.55–2.57, P〈0.001）. Among all the clinicopathologic factors, PD-L1 overexpression was significantly in relevance with poor tumor cell differentiation（HR=1.84, 95% CI： 1.49–2.28, P〈0.001）, late stage（HR=1.21, 95% CI： 1.02–1.43, P=0.026） and anaplastic lymphoma kinase（ALK） translocation（HR=2.63, 95% CI： 1.08–6.40, P=0.034）, but not with other factors. In conclusion, our meta-analysis demonstrated that PD-L1 has a prognostic role in Asian patients with NSCLC.

The diagnostic value of the expression of the thymidine kinase 1 in lung cancer:A meta analysis

Objective:To study is to evaluate the diagnostic value of the expression of thymidine kinase 1(TK1)in lung cancer through literature review and meta-analysis.Methods:Firstly,we searched Pubmed,Embase,Cochrane,Web of Science,CBM,CNKI,Wanfang and other databases up to June 2022.Then two researchers separately selected the clinical study on diagnosis of lung cancer by the expression of the TK1 and treatment and obtained the full text of the literature.Then we evaluated the systematic quality and bias risk of the included literatures by using Revman 5.3 software,and the consistency among the covariables in meta analysis.Finally,the Sensitivity(Sen),the Specificity(Spe)and other indicators were analyzed by using Stata16.0 software.Results:The study included 37 literatures,including 3218 lung cancer cases and 2976 control cases.The meta-analysis showed that the Ser and Spe of the expression of the TK1 in the diagnosis of lung cancer were 0.63(95%CI:0.57,0.68)and 0.88(95%CI:0.84,0.91),while positive likelihood ratio(PLR)was 5.34(95%CI:4.02,7.1)and negative likelihood ratio(NLR)was 0.42(95%CI:0.37,0.48),diagnostic odd sratio(DOR)was 12.69(95%CI:8.91,18.08),and the area under the ROC curve(AUC)was 0.82(95%CI:0.79,0.85).When TK1,CEA and CYFRA21-1 were used as combined diagnostic indexes of lung cancer,Sen was 0.82(95%CI:0.76,0.86),Spe 0.78(95%CI:0.46,0.94),PLR 3.69(95%CI:1.28,10.66),NLR 0.24(95%CI:0.18,0.31),DOR 15.59(95%CI:4.56,53.36),AUC 0.84(95%CI:0.80,0.87).The Youden index of combined diagnosis was 0.60,which was higher than that of TK1 alone.Conclusion:TK1 alone as a diagnostic index of lung cancer has low Sen,but its Sep is higher.So it has a certain diagnostic value.TK1 combined with CEA and CYFRA21-1 has higher Sen in the diagnosis of lung cancer,and the diagnostic value is better.

Efficacy and Safety of Gefitinib or Platinum plus Taxane in Egfr-Mutant Advanced Non-Small Cell Lung Cancers: A Meta-Analysis of First-Line Randomized Controlled Trials

Purpose: The discovery of EGFR mutations renewed interest in lung cancer translational research since EGFR-dependent pathway plays an important role in the development and progression of human epithelial cancers, including non-small cell lung cancer (NSCLC). The present meta-analysis was performed to review the recent advances with the selective oral EGFR-TK inhibitor gefitinib among EGFR mutation positive patients with NSCLC. Methods: Using the keywords “gefitinib” and “lung cancer” MEDLINE was searched. The primary reports of interest were the randomized controlled trials in NSCL published in peer-reviewed journals. Three recent studies concerning the effect of gefitinib in NSCLC were identified to be relevant for the meta-analysis based on their similarity in terms of study design. PFS and objective response rate (ORR) in gefitinib and platinum/taxane combination were compared by the Hazard ratio (HR) or Odds Ratio (OR) of meta-analysis. Results: The HR (95%CI) of the meta-analysis of 0.41 (0.34 - 0.49) demonstrated that in patients EFGR mutation positive patients, PFS was significantly longer among those who received gefitinib compared to platin derivative/taxane combination. Furthermore, OR of the meta-analysis for ORR was 3.83 (2.72 - 5.40). While hematological toxicity was observed in the majority of the taxane/platinum group, major adverse events in gefitinib patients were skin rashes/acnea, dry skin, elevated liver enzymes and diarrhea. Conclusions: This meta-analysis strongly confirms the efficacy and better tolerability of gefitinib in EGFR positive NSCLC, and the importance of EGFR mutation testing in order to plan first-line treatment in routine clinical practice in NSCLC.

miR-21的高表达与肺癌预后关系的meta分析

目的:评价miR-21的高表达与肺癌预后的相关性。方法:检索PubMed,EMBASE,Google scholar,维普,CNKI等数据库,收集已公开发表的关于miR-21的高表达与肺癌预后相关性的文献,按meta分析的要求对原始文献的质量进行评估,采用STATA V12.0软件对各研究的效应量进行统计分析。结果:共纳入7篇文献(共369个病例),总生存率(OS)HR的合并值为1.34(95%CI:1.19至1.50,P<0.05)。结论:miR-21的高表达是肺癌预后的一个危险因素。

女性吸烟与肺癌关系的Meta-analysis

本文应用Meta—analysis方法对国内12个有关女性吸烟与肺癌关系的病例对照研究进行了定量合并分析。采用固定效应模型和随机效应模型处理数据。女性吸烟因素合并OR为2.18(95％可信限:1.93～2.48),PAR为30.34％;吸烟量、吸烟年数及开始吸烟年龄与患肺癌OR间存在剂量反应关系;患鳞癌的合并OR和PAR分别为7.45(5.21～10.67)和53.97％;而患腺癌分别为1.09(0.82～1.44)和1.65％;被动吸烟合并OR为1.004(0.74～1.35),PAR为0.16％。另对可能的偏倚与混杂进行了讨论。

miR-21的高表达在结直肠癌预后中的meta分析

目的:评价miR-21的高表达与结直肠癌预后的相关性。方法:通过全面检索PubMed、EMBASE、Google scholar、维普、CNKI等数据库,收集关于miR-21的高表达与结直肠癌预后相关性的文献,用meta分析方法评价miR-21的高表达是否与结直肠癌的预后相关。结果:共纳入4篇文献(共783个病例),总生存率(OS)HR的合并值为1.42,95%CI:1.21至1.66,P<0.05。结论:miR-21的高表达是结直肠癌预后的一个危险因素。

miR-21的高表达与乳腺癌预后关系的meta分析

目的:评价miR-21的高表达与乳腺癌预后的相关性。方法:检索PubMed,MEDLINE,EMBASE,Web of science,维普,CNKI数据库,收集从建库至2013年9月期间关于miR-21的高表达与乳腺癌预后相关性的文献,用meta分析方法评价miR-21的高表达是否与乳腺癌的预后相关。结果:共纳入4篇文献(总计548个病例),总生存率(OS)HR的合并值为1.61(95%CI:1.09至2.37,P<0.05)。结论:miR-21的高表达是乳腺癌预后的一个危险因素。

预防性护理对肺癌患者治疗后深静脉血栓形成率的临床效果:A meta-analysis

目的:研究预防性护理干预对肺癌治疗后深静脉血栓形成率,护理满意度和平均住院时间的临床效果。方法:检索中文数据库(万方,维普以及中国知网)和英文数据库(Pubmed,Cochrane以及Scopus),并阅读相关研究的参考文献。采用Review Manager 5.3进行统计分析,比值比(odds ratio,OR)和平均差(mean difference,MD)作为比较组的合并效应值。改变效应模型或排除权重比大的文献进行敏感性分析,观察漏斗图对称性进行发表偏倚检验。结果:共纳入14篇中文研究。与常规护理干预比较,预防性护理干预可以明显降低肺癌治疗后深静脉血栓形成率[OR=0.16(0.10,0.23)],提高护理满意度[OR=6.42(3.32,12.41)]和缩短平均住院时间[MD=-7.41(-8.16,-6.65)],结果均没有异质性存在。而且不管肺癌患者是行切除术还是化疗,预防性护理干预降低深静脉血栓形成率的效果均十分显著。结论:预防性护理干预可能对肺癌患者大有裨益,可以降低深静脉血栓的形成率,具有一定的临床借鉴意义。

MiR-21对乳腺癌诊断价值的Meta分析

目的应用Meta分析的方法评价microRNA-21(miR-21)在乳腺癌患者诊断中的价值。方法检索1990年至2018年在Pubmed、Embase、Medline等英文数据库及1990年至2018年在中国知网、万方及维普数据库收录的所有有关miR-21用于乳腺癌诊断的研究文献,根据纳入与排除标准筛选文献,提取原始有效数据后,利用Med-Disc1.4进行统计分析。结果共有11篇文献纳入相关临床研究,11个独立的病例对照研究,其中包含乳腺癌患者761例,健康对照组652例。miR-21用于诊断乳腺癌的合并灵敏度和特异性分别为0.66(95%CI0.63~0.70)和0.82(95%CI0.79~0.82),阳性似然比和阴性似然比分别为4.12(95%CI2.60~6.52)和0.33(95%CI0.21~0.52);其DOR为13.31(95%CI5.59~31.68);SROC-AUC为0.898。亚组分析显示miR-21对于血清标本和非亚洲人的诊断优势高于非血清标本和亚洲人。结论评价结果提示miR-21在乳腺癌诊断中有一定的精确性,可作为重要的参考指标。

Systematic review and meta analysis of the TCM therapy of Fuzheng and Kangai combined with chemotherapy in treating advanced NSCLC

Objective:To systematically evaluate TCM of Fuzheng and Kangai combined with chemotherapy in the treatment of Advanced NSCLC,including the efficacy and effect on the quality of life of patients.Methods:Two researchers independently searched the literature of clinical trails from Jan.2010 until Jun.2020 in the Cochrane Library,Pubmed,Embase,CBM,CNKI,WanFang Data and VIP database.Also,they had been evaluated and extracted strictly by REVMAN 5.3.Results:A total of 1303 patients were included in 15 articles.The meta analysis shows that the TCM of Fuzheng and Kangai combined with chemotherapy can improve the objective response rate[OR=2.14,95%CI(1.67,2.74),P<0.00001],disease control rate[OR=2.54,95%CI(1.88,3.42),P<0.00001]and KPS score[OR=3.28,95%CI(1.92,5.60),P<0.0001],decrease the incidence rate of liver injury[OR=0.34,95%CI(0.21,0.54),P=0.003],hemoglobin reduction[OR=0.53,95%CI(0.28,1.01),P=0.05],leukopenia[OR=0.22,95%CI(0.13,0.39),P<0.00001],thrombocytopenia[OR=0.32,95%CI(0.21,0.50),P<0.00001],toxic effects on the digestive systems[OR=0.30,95%CI(0.19,0.46),P<0.00001].Conclusions:the experimental group was better than control one in short-term efficacy and KPS score.Furthermore,the experimental group can reduce the incidence rate of myelosuppression,toxicity of digestive system and liver.

Prognostic Role of miR-205 in Early-Stage (T1N0) Non-Small Cell Lung Cancer

Background: Published data have shown that microRNAs (miRNAs) could play a potential role as diagnostic and prognostic indicators in cancers. Data for the predictive value of miRNA let-7, miR-21, and miR-205 are inconclusive. The aim of the present analysis was therefore to evaluate the expression and the prognostic role of the above mentioned miRNAs?in early-stage?(T1N0) NSCLC patients. Methods: Quantification of let-7g, miR-21, and miR-205 expression was carried out into 105 early-stage NSCLC by quantitative Real Time-PCR (qRT-PCR).?Results: a significant association between the low miR-205 expression and ADC histotype (p??0.0001) compared to SCC?was found;moreover, survival analysis showed thattumors with a high?miR-205 expression had a significantly shorter mean PFS and OS compared to the patients with a low expression of this miRNA (p = 0.02 and p = 0.03, respectively). No other statistically significant correlations were observed between the analysed miRNAs and the main clinico-pathological characteristics of the NSCLC patients. Conclusion: The results indicated that miR-205 could represent a useful marker in the prognostic management of the early-stage (T1N0) NSCLC patients.

miR-21的高表达与胰腺癌预后关系的meta分析

为评价miR-21的高表达与胰腺癌预后的相关性,通过全面检索Pub Med,EMBASE,Google scholar,维普,CNKI等数据库,收集已公开发表的关于miR-21的高表达与胰腺癌预后相关性的文献,按meta分析的要求对原始文献的质量进行评估,采用STATA V12.0软件对各研究的效应量进行统计分析。结果发现共纳入4篇文献(共300个病例),合并总生存率(OS)HR为1.26(95%CI:1.08~1.47,P<0.05)。由此可以推断胰腺癌预后的一个危险因素为miR-21的高表达。

CYFRA21-1对早期非小细胞肺癌诊断价值的Meta分析

目的评价CYFRA21-1对早期非小细胞肺癌诊断的价值。方法收集已公开发表的有关CYFRA21-1对早期非小细胞肺癌诊断价值的文献,按Meta分析的要求对检索到的原始研究的质量进行评估,对符合条件的所有研究结果进行Meta分析。结果共纳入9篇文献,其中中文文献6篇,英文文献3篇,样本量为670例,其中经病理学确诊的Ⅰ、Ⅱ期及可手术治疗的NSCLC为276例,异质性检验显示纳入研究齐性较好,通过确定模型的汇总计算得出汇总敏感度为41%(35%～46%),汇总特异度为94%(91%～96%),汇总阳性预测值为5.65(3.45～9.27),汇总阴性预测值为0.64(0.54～0.76),合并受试者工作特征曲线(SROC)的曲线下面积为0.85。结论 CYFRA21-1对早期非小细胞肺癌有一定的诊断价值,可作为较重要的参考指标之一,但需要更多高质量、大样本、多中心的研究加以验证。

血清CYFRA21-1、CEA及NSE对非小细胞肺癌诊断价值的Meta分析

目的系统评价血清细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)及神经元特异性烯醇化酶(NSE)对非小细胞肺癌(NSCLC)的诊断价值。方法计算机检索Cochrane图书馆、Medline、CBMDisc、CNKI及万方数据库,检索年限均从建库到2010年10月,收集有关CYFRA21-1、CEA及NSE诊断NSCLC的临床研究,手工检索纳入研究的参考文献及杂志、会议论文集、学位论文汇编等。根据Cochrane系统评价方法筛选研究并提取数据,采用Meta Disc 1.4版软件进行Meta分析。结果 14个研究符合纳入标准,其中病例组1145例,对照组855例。Meta分析结果显示,血清CYFRA21-1的诊断优势比(DOR)为14.80(95%CI:9.56～22.91),灵敏度为61%(95%CI:58%～64%),特异度为85%(95%CI:83%～87%);血清CEA的DOR为9.31(95%CI:5.18～16.71),灵敏度为50%(95%CI:46%～55%),特异度为89%(95%CI:85%～92%);血清NSE的DOR为5.77(95%CI:3.34～9.97);灵敏度为24%(95%CI:20%～28%),特异度为94%(95%CI:91%～97%);血清CYFRA21-1与CEA联合检测的DOR为14.20(95%CI:6.12～32.95),灵敏度为75%(95%CI:65%～83%),特异度为82%(95%CI:70%～91%);血清CYFRA21-1、CEA及NSE三项联合检测的DOR为37.96,灵敏度为51%,特异度为97%。结论血清CYFRA21-1检测对NSCLC的诊断效能优于CEA和NSE,其中两项或三项联合检测的诊断效能优于单项检测。

MicroRNA-21对结直肠癌诊断价值的Meta分析

目的应用Meta分析评价血液(血清、血浆)及粪便标本中micro RNA-21(mi R-21)表达用于结直肠癌诊断的临床价值。方法联合应用Cochrane library、Pub Med、EMbase、Google学术、CNKI等检索micro RNA-21用于结直肠癌诊断的文献,按PRISMA声明的标准筛选文献以及进行QUADAS-2质量评价后,用固定效应模型或随机效应模型合并得到汇总的灵敏度(SEN)、特异度(SPE)、阳性似然比(PLR)、阴性似然比(NLR)和诊断优势比(DOR),受试者工作特征曲线(SROC)及曲线下面积(AUC)用于评价整体诊断效能。结果最终纳入14篇文献,包括1199例结直肠癌患者和784例正常对照者。Meta分析结果显示:血清mi R-21的汇总DOR、SEN和SPE分别为13.97(95%CI:8.56-22.81)、0.73(95%CI:0.69-0.77)、0.83(95%CI:0.76-0.89);血浆mi R-21的汇总DOR、SEN和SPE分别为8.03(95%CI:3.30-19.52)、0.67(95%CI:0.60-0.73)、0.76(95%CI:0.69-0.81);粪便mi R-21的汇总DOR、SEN和SPE分别为4.78(95%CI:1.46-15.69)、0.31(95%CI:0.27-0.36)、0.88(95%CI:0.84-0.91)。除此之外,血清、血浆和粪便mi R-21诊断结直肠癌的AUC分别为0.8701、0.8295和0.6991。结论血液标本mi R-21用于结直肠癌诊断具有良好的灵敏度和特异度,且血清标本的检测结果优于血浆标本;粪便mi R-21诊断结直肠癌灵敏度较差但特异性好。