miRNA-210对早期肺癌诊断价值的Meta分析

Meta Analysis of the Value of miRNA-210 in the Diagnosis of Early Lung Cancer

摘要: 目的：探究循环血液中miRNA-210对早期肺癌的诊断价值。方法：通过检索PubMed、Embase、中国知网、万方、谷歌学术等数据库，搜集2010年1月1日至2021年1月1日公开发表的相关文献，限制语种为英语或者汉语。严格按照事先制定的纳入排除标准，并使用QUADAS-2量表对文献进行质量评估。纳入文献累计样本量916例，其中实验组560例，良性对照组356例。用STATA (version 15.1)软件对纳入文献诊断的效应量进行合并，计算出合并的敏感性(SEN)、特异性(SPE)、阳性似然比(PLR)、阴性似然比(NLR)、诊断优势比(DOR)和ROC曲线下面积(AUC)进行综合分析，以评估miRNA-210在肺癌诊断中的准确性。此外，还进行了亚组分析，以区分研究之间的异质性的潜在来源。绘制Deek’s漏斗图评估是否存在发表偏移。最后绘制Fagan’s列线图评估其临床应用价值。结果：对于miRNA-210在早期肺癌中的诊断分析，合并SEN和SPE分别为0.70 (95% CI: 61~77%)和0.78 (95% CI: 72~84%)。PLR和NLR分别为3.24 (95% CI: 2.57~4.08)和0.38 (95% CI: 0.30~0.49)。同时，合并DOR为8.42 (95% CI: 6.03~11.77)，SROC下面积(AUC)为0.81 (95% CI: 0.78~0.85)，表明miRNA-210在肺癌检测中具有显著价值。结论：以上指标均表明循环血液中miRNA-210对早期肺癌有显著诊断价值，可以作为肺癌筛查的潜在生物标志物。

Abstract: Objective: To explore the diagnostic value of miRNA-210 in circulating blood for early stage of lung cancer. Methods: PubMed, Embase, CNKI, Wanfang and Google academic databases were searched to collect relevant literatures published from January 1, 2010 to January 1, 2021 in English or Chi-nese. According to the inclusion and exclusion criteria, QUADAS-2 was used to evaluate the quality of the literature. A total of 916 cases were included, including 560 cases in the experimental group and 356 cases in the benign control group. The combined sensitivity (SEN), specificity (SPE), posi-tive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under ROC curve (AUC) were calculated by STATA (version 15.1) software to evaluate the accuracy of miRNA-210 in the diagnosis of early stage of lung cancer. In addition, subgroup analysis was per-formed to identify potential sources of heterogeneity between studies. Draw a funnel chart to eval-uate whether there is publication bias. Finally, Fagan’s nomogram was drawn to evaluate its clinical application value. Results: For the diagnostic analysis of miRNA-210 in early stage of lung cancer, the combined SEN and SPE were 0.70 (95% CI: 61~77%) and 0.78 (95% CI: 72~84%) respectively. PLR and NLR were 3.24 (95% CI: 2.57~4.08) and 0.38 (95% CI: 0.30~0.49), respectively. Mean-while, the combined DOR was 8.42 (95% CI: 6.03~11.77), and the area under SROC (AUC) was 0.81 (95% CI: 0.78~0.85), indicating that miRNA-210 has significant value in the detection of early stage of lung cancer. Conclusion: The above indicators indicate that miRNA-210 in circulating blood has significant diagnostic value for early stage of lung cancer, and can be used as a potential biomarker for lung cancer screening.