Abstract: 【Abstract】〓Objective〓To assess the diagnosis value of microRNA-21 in tissues, feces, serum, and plasma for systematic diagnosis of CRC using Meta-analysis. Methods〓Databases, including Cochrane library, PubMed, EMbase, Google Scholar, and Chinese National Knowledge Infrastructure, were scanned to retrieve relevant articles focusing on microRNA-21 in CRC diagnosis. Articles were then filtered according to the PRISMA statement and assessed by quality assessment of diagnosis accuracy studies-2. Sensitivity (SEN), specificity (SPE), positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) were pooled using fixed-effects model or random-effects model. Summary receiver operating characteristic (SROC) curve and area under the curve (AUC) were used to estimate the overall diagnostic performance. Results〓A total of 15 studies, comprising 1268 CRC patients and 910 healthy controls, were enrolled in this meta-analysis. For serum miR-21, the pooled DOR, SEN, and SPE were 13.97 (95% CI: 8.44-23.11), 0.73 (95% CI: 0.69-0.77), and 0.83 (95% CI: 0.76-0.89), respectively; for plasma miR-21, the pooled DOR, SEN, and SPE were 8.03 (95% CI: 3.30-19.52), 0.67 (95% CI: 0.60-0.73), and 0.76 (95% CI: 0.69-0.81), respectively; and for fecal miR-21, the pooled DOR, SEN, and SPE were 7.06 (95% CI: 2.17-22.95), 0.33 (95% CI: 0.28-0.37), and 0.91 (95% CI: 0.88-0.93), respectively. Moreover, the AUC values of serum, plasma, and fecal miR-21 in CRC diagnosis were 0.8701, 0.8295, and 0.6742, respectively. Conclusion〓Circulation miR-21 demonstrates good diagnostic performance, and serum samples are better than plasma samples in CRC diagnosis. For fecal miR-21, the sensitivity is unsatisfactory, but the specificity is favorable in predicting CRC patients.

Key words: Colorectal cancer, Diagnosis, Meta-analysis, microRNA-21

摘要： 【摘要】 目的 应用 Meta 分析评价血液(血清、血浆)及粪便标本中microRNA-21(miR-21)表达用于结直肠癌诊断的临床价值。方法〓联合应用Cochrane library、PubMed、EMbase、Google学术、CNKI等检索microRNA-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miR-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miR-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miR-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miR-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miR-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miR-21诊断结直肠癌灵敏度较差但特异性好。

关键词: microRNA-21, 诊断, 结直肠癌, Meta 分析