■多发性骨髓瘤(MM)是第二种无法治愈的血液恶性肿瘤。近年来,由于microRNA(miRNA)的兴起,许多学者参与了其在MM诊断中的价值研究,并获得了良好但不一致的结果。因此,为了确定miRNA在MM早期诊断中的作用,我们进行了荟萃分析.
■我们搜索了相关研究,包括PubMed,WebofScience,EMBASE,科克伦图书馆,中国国家知识基础设施(CNKI)和万方数据库截至2020年7月20日进行本元分析。为了提高准确性,使用诊断准确性研究2(QUADAS-2)的质量评估.我们还应用随机效应模型来总结敏感性和特异性,正似然比(PLR),负似然比(NLR),诊断比值比(DOR)和曲线下面积(AUC)来测量诊断值,和亚组分析用于发现潜在的异质性来源。
■我们最终从15篇文章中收集了32项研究,其中包括2053例MM患者和1118例健康对照。整体灵敏度,特异性,PLR,NLR,DOR和AUC分别为0.81、0.85、5.5、0.22、25和0.90。亚组分析显示,血浆类型样本量较大的microRNA簇下调可以对MM患者进行更好的诊断准确性。此外,未发现发表偏倚.
■循环miRNA可能是MM早期诊断的潜在非侵入性生物标志物。然而,多中心,更严格,需要更大规模的研究来验证我们的结论.
BACKGROUND: Multiple myeloma (MM) is the second incurable hematological malignancy. In recent years, due to the rise of microRNA (miRNA), many scholars have participated in the study of its value in the diagnosis of MM, and have obtained good but inconsistent results. Therefore, in order to determine the role of miRNA in the early diagnosis of MM, we performed this meta-analysis.
METHODS: We searched for related studies including PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Database as of July 20, 2020 to conduct this meta-analysis. To improve the accuracy, the quality assessment of Diagnostic Accuracy Study 2 (QUADAS-2) was used. We also applied random effects models to summarize sensitivity and specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the curve (AUC) to measure diagnostic values, and subgroup analysis used to discover potential sources of heterogeneity.
RESULTS: We finally collected 32 studies from 15 articles that included a total of 2053 MM patients and 1118 healthy controls in this meta-analysis. The overall sensitivity, specificity, PLR, NLR, DOR and AUC were 0.81, 0.85, 5.5, 0.22, 25 and 0.90, respectively. Subgroup analysis shows that the down-regulation of microRNA clusters with larger samples size of plasma type could carry out a better diagnostic accuracy of MM patients. In addition, publication bias was not found.
CONCLUSIONS: Circulating miRNA could be a potential non-invasive biomarker for early diagnosis of MM. However, multi-center, more rigorous, and larger-scale studies are needed to verify our conclusions.