Blood-based microRNAs as biomarkers for the diagnosis of colorectal cancer: a systematic review and meta-analysis.
Blood-based microRNAs as biomarkers for the diagnosis of colorectal cancer: a systematic review and meta-analysis.
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DOI：
10.1038/bjc.2017.12
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发表时间：
2017-03-14
影响因子：
8.8
通讯作者：
Galandiuk S
中科院分区：
文献类型：
--
作者：
Carter JV;Galbraith NJ;Yang D;Burton JF;Walker SP;Galandiuk S
结直肠癌（CRC）是常见的并且与显著的死亡率相关。目前的CRC筛查方法缺乏患者依从性。在体液中鉴定的microRNA（miRNAs）是基因表达的负调节因子，并且在许多癌症（包括CRC）中失调。本文总结了与健康对照组相比，鉴定CRC中基于血液的miRNAs失调的研究，试图评估其作为诊断CRC的筛选工具的用途。检索了2002年1月至2016年4月期间的电子数据库（PubMed和EMBASE）和灰色文献。选择报告血浆或血清miRNA与健康对照相比诊断CRC的研究。记录患者人口统计学、患者样品类型（血清或血浆）、miRNA检测方法、标准化类型和鉴定的显著失调的miRNA的数量。使用灵敏度、特异性和曲线下面积（AUC）对失调的miRNA进行统计学评估。纳入了34项研究血浆或血清miRNA在CRC诊断中的作用的研究。与对照组相比，共发现31种miRNA在CRC病例中上调（n=17）或下调（n=14）。14项研究鉴定了一组miRNAs失调的miRNAs。最高AUC为0.943，使用具有83.3%灵敏度和93.1%特异性的4种miRNA的组鉴定。对鉴定CRC病例与对照组相比的单个失调miRNA的研究进行荟萃分析。28种miRNA诊断结直肠癌的总体敏感性和特异性分别为76%（95%CI 72%-80%）和76%（95%CI 72%-80%），表明miRNA作为结直肠癌生物标志物的良好区分能力。这些数据在敏感性分析中没有变化。基于血液的miRNAs将CRC患者与健康对照区分开来，其灵敏度和特异性与目前使用的其他常见和侵入性CRC筛查方法相当。在未来，miRNA可能被用作一种相对非侵入性的血液标记物，用于检测CRC。
Colorectal cancer (CRC) is common and associated with significant mortality. Current screening methods for CRC lack patient compliance. microRNAs (miRNAs), identified in body fluids, are negative regulators of gene expression and are dysregulated in many cancers, including CRC. This paper summarises studies identifying blood-based miRNAs dysregulated in CRC compared with healthy controls in an attempt to evaluate their use as a screening tool for the diagnosis of CRC. A search of electronic databases (PubMed and EMBASE) and grey literature was performed between January 2002 and April 2016. Studies reporting plasma or serum miRNAs in the diagnosis of CRC compared with healthy controls were selected. Patient demographics, type of patient sample (serum or plasma), method of miRNA detection, type of normalisation, and the number of significantly dysregulated miRNAs identified were recorded. Statistical evaluation of dysregulated miRNAs using sensitivity, specificity, and area under the curve (AUC) was performed. Thirty-four studies investigating plasma or serum miRNAs in the diagnosis of CRC were included. A total of 31 miRNAs were found to be either upregulated (n=17) or downregulated (n=14) in CRC cases as compared with controls. Fourteen studies identified panels of ⩾2 dysregulated miRNAs. The highest AUC, 0.943, was identified using a panel of 4 miRNAs with 83.3% sensitivity and 93.1% specificity. Meta-analysis of studies identifying a single dysregulated miRNA in CRC cases compared with controls was performed. Overall sensitivity and specificity of 28 individual miRNAs in the diagnosis of CRC were 76% (95% CI 72%–80%) and 76% (95% CI 72%–80%), respectively, indicating good discriminative ability of miRNAs as biomarkers for CRC. These data did not change with sensitivity analyses. Blood-based miRNAs distinguish patients with CRC from healthy controls with high sensitivity and specificity comparable to other common and invasive currently used screening methods for CRC. In future, miRNAs may be used as a relatively non-invasive blood-based marker for detection of CRC.