背景:尽管存在大量研究血液微小RNA对结直肠癌的诊断潜力,所考虑的microRNAs差异很大,缺乏对其诊断价值的比较分析。因此,本系统综述旨在确定最有效的microRNA血液肿瘤标志物,以增强结直肠癌筛查的临床决策.
方法:对数据库的全面搜索,包括PubMed,Embase,WebofScience,Scopus,还有Cochrane,进行病例对照或队列研究,以检查外周血microRNAs在结直肠癌中的诊断价值。如果研究提供了敏感性和特异性数据,以英文出版,并在2000年1月1日至2023年2月10日之间提供。关键评估技能计划(CASP)清单用于质量评估。进行了贝叶斯网络荟萃分析,以估计综合风险比(RR)和95%置信区间(CI),结果通过rankographs呈现。本研究已在国际注册系统评价和荟萃分析协议平台(INPLASY)注册,20238092。
结果:从最初的2254条记录池中,79符合纳入标准,包括总共90个microRNA。选择了七个最常研究的microRNA(43条记录)进行纳入,所有这些都表现出中等到高质量。miR-23、miR-92和miR-21表现出最高的敏感性和准确性,在敏感性和准确性方面,RR值和95%CI优于传统肿瘤标志物CA19-9和CEA。除miR-17外,在特异性方面,在每种微小RNA与CA19-9和CEA之间没有观察到显著差异。
结论:在研究最广泛的血液microRNAs中,miR-23,miR-92和miR-21由于其出色的敏感性和准确性,对结直肠癌具有优越的诊断价值。该系统综述和网络荟萃分析可为临床选择microRNA作为肿瘤生物标志物提供有价值的参考。
BACKGROUND: Despite the existence of numerous studies investigating the diagnostic potential of blood microRNAs for colorectal cancer, the microRNAs under consideration vary widely, and comparative analysis of their diagnostic value is lacking. Consequently, this systematic
review aims to identify the most effective microRNA blood tumor markers to enhance clinical decision-making in colorectal cancer screening.
METHODS: A comprehensive search of databases, including PubMed, Embase, Web of Science, Scopus, and Cochrane, was conducted to identify case‒control or cohort studies that examined the diagnostic value of peripheral blood microRNAs in colorectal cancer. Studies were included if they provided sensitivity and specificity data, were published in English and were available between January 1, 2000, and February 10, 2023. The Critical Appraisal Skills Programme (CASP) checklist was employed for quality assessment. A Bayesian network meta-analysis was performed to estimate combined risk ratios (RRs) and 95% confidence intervals (CIs), with results presented via rankograms. This study is registered with the International Platform of Registered Systematic
Review and Meta-analysis Protocols (INPLASY), 202,380,092.
RESULTS: From an initial pool of 2254 records, 79 met the inclusion criteria, encompassing a total of 90 microRNAs. The seven most frequently studied microRNAs (43 records) were selected for inclusion, all of which demonstrated moderate to high quality. miR-23, miR-92, and miR-21 exhibited the highest sensitivity and accuracy, outperforming traditional tumor markers CA19-9 and CEA in terms of RR values and 95% CI for both sensitivity and accuracy. With the exception of miR-17, no significant difference was observed between each microRNA and CA19-9 and CEA in terms of specificity.
CONCLUSIONS: Among the most extensively researched blood microRNAs, miR-23, miR-92, and miR-21 demonstrated superior diagnostic value for colorectal cancer due to their exceptional sensitivity and accuracy. This systematic
review and network meta-analysis may serve as a valuable reference for the clinical selection of microRNAs as tumor biomarkers.