Diagnostic and Prognostic Value of microRNA-21 in Colorectal Cancer: An Original Study and Individual Participant Data Meta-analysis
Diagnostic and Prognostic Value of microRNA-21 in Colorectal Cancer: An Original Study and Individual Participant Data Meta-analysis
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microRNA-21 在结直肠癌中的诊断和预后价值：一项原始研究和个体参与者数据荟萃分析。
DOI：
10.1158/1055-9965.epi-14-0598
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发表时间：
2014-12-01
影响因子：
3.8
通讯作者：
Wu, Yihua
中科院分区：
文献类型：
--
作者：
Zhang, Honghe;Li, Peiwei;Wu, Yihua
背景资料：本研究旨在系统总结循环/组织miR 21在结直肠癌诊断和预后中的价值。方法：本研究旨在探讨循环miR 21在结直肠癌诊断中的潜在价值和组织miR 21在结直肠癌预后中的潜在价值。检索了PUBMED和EMBASE（截至2013年8月），以识别合格的研究。为了探索循环miR 21的诊断性能，使用荟萃分析方法来汇集灵敏度、特异性、阳性和阴性似然比、诊断OR并构建概括ROC曲线。对于预后荟萃分析，总结了组织miR 21对生存期的研究特异性HR。结果：最终纳入14篇文献（包括本研究）。在诊断结直肠癌中，循环miR 21的合并灵敏度、特异性和AUC为0.76 [95%置信区间（CI），0.59-0.88]、0.81（95% CI，0.76-0.85）和0.81（95% CI，0.78-0.85）。组织miR 21表达较高的患者的总生存期（OS;合并HR，1.56; 95%CI，1.16-2.11）和无病生存期（DFS;合并HR，1.35; 95%CI，1.08-1.69）显著较差。个体参与者数据（IPD）荟萃分析表明，组织miR 21水平与结直肠癌OS恶化独立相关（HR，1.69; 95% CI，1.07-2.67; P = 0.023），而这种关联似乎仅限于男性（P = 0.007），但女性不适用（P = 0.845）。结论：循环中miR 21水平对结直肠癌的早期检测具有潜在价值，而组织中miR 21水平高与结直肠癌的不良预后相关。miR 21是结直肠癌早期检测和预后的一个有前途的生物标志物。(C)2014年AACR。
Background: We aimed to systematically summarize the diagnostic and prognostic value of circulating/tissue miR21 in patients with colorectal cancer.Methods: An original study was conducted to explore the potential value of circulating miR21 in colorectal cancer diagnosis and tissue miR21 in colorectal cancer prognosis. PUBMED and EMBASE were searched (to August, 2013) to identify eligible studies. To explore the diagnostic performance of circulating miR21, meta-analysis methods were used to pool sensitivity, specificity, positive and negative likelihood ratio, diagnostic OR and to construct a summary ROC curve. For prognostic meta-analysis, study-specific HRs of tissue miR21 for survival were summarized. Subgroup and sensitivity analyses were applied to explore heterogeneity.Results: Finally, 14 studies (including our study) were included in the meta-analyses. The pooled sensitivity, specificity, and AUC of circulating miR21 were 0.76 [95% confidence interval (CI), 0.59-0.88], 0.81 (95% CI, 0.76-0.85), and 0.81 (95% CI, 0.78-0.85) in diagnosing colorectal cancer. Patients with higher expression of tissue miR21 had significant inferior overall survival (OS; pooled HR, 1.56; 95% CI, 1.16-2.11) and disease-free survival (DFS; pooled HR, 1.35; 95% CI, 1.08-1.69). The individual participant data (IPD) meta-analysis demonstrated that tissue miR21 level was independently associated with worse colorectal cancer OS (HR, 1.69; 95% CI, 1.07-2.67; P = 0.023), whereas this association seems to be confined to males (P = 0.007) but not for females (P = 0.845).Conclusions: Circulating miR21 level has potential value for colorectal cancer early detection, whereas high tissue miR21 level is associated with adverse colorectal cancer prognosis.Impact: miR21 is a promising biomarker for early detection and prognosis of colorectal cancer. (C) 2014 AACR.