环状RNA用于肝细胞癌诊断的Meta分析  

Meta-analysis of the Diagnostic Efficacy of Circular RNAs in Hepatocellular Carcinoma

作　　者：田忠昌 褚志杰 杨天保[1] 刘伟峰[1] 杨延辉[1] 孙君军[1] Tian Zhongchang;Chu Zhijie;Yang Tianbao(Department of Hepatobiliary Surgery,The First Affiliated Hospital,and College of Clinical Medicine of Henan University of Science and Technology,Henan 471003,China)

机构地区：[1]河南科技大学临床医学院、河南科技大学第一附属医院肝胆外科

出　　处：《医学研究杂志》2019年第10期157-161,共5页Journal of Medical Research

基　　金：河南科技大学创新基金资助项目(4032-13350049)

摘　　要：目的系统性评价环状RNA(circular RNA,circRNA)在肝细胞癌(hepatocellular carcinoma,HCC)诊断中的综合效能。方法检索PubMed、EMBASE、知网(CNKI)等在线数据库纳入相关文献;采用诊断试验质量评价QUADAS-2工具评估文献质量;通过Meta-DiSc 1.4软件合并诊断效应指标,并进行亚组分析和敏感度分析探讨研究异质性。结果共纳入符合标准的文献10篇,包含858例HCC患者和885例非癌对照。circRNA用于诊断HCC和非肿瘤对照的合并敏感度为78%(95%CI:76%~80%),特异性为78%(95%CI:75%~80%),相应曲线下面积(AUC)为0.877。亚组分析结果显示,血清来源的circRNA用于HCC的检测效能(AUC=0.929)优于组织(AUC=0.859)和血浆(AUC=0.724);circRNA在区分HCC和健康对照时效能最高(AUC=0.929),而区分HCC和肝炎/肝硬化时效能较低(AUC=0.730);上调的circRNA表达谱综合诊断效能高于下调的circRNA(AUC:0.863 vs 0.836);circRNA表达检测用于HCC诊断的效能在亚洲人群中高于非洲人群(AUC:0.929 vs 0.854);此外,基于不同参考基因的circRNA分析也具有较大的效能差异。结论circRNA表达检测有望作为HCC较好的辅助诊断指标,值得临床推广。Objective To evaluate the overall diagnostic efficacy of circular RNA(circRNA)in hepatocellular carcinoma(HCC).Methods The online databases included PubMed,EMBASE,CNKI,WANFANG and WEIPU were reviewed,wherein studies assessed the diagnostic performance of circRNA(s)in HCC were included.Study quality was judged in line with the QUADAS-2 checklist.Statistical analyses were conducted using Meta-Disc 1.4.Study heterogeneity was assessed by sub-group study and influence analysis.Results A total of 10 eligible studies were enrolled,containing 858 HCC patients and 885 paired non-cancerous controls.circRNA signature yielded a pooled sensitivity of 78%(95%CI:76%-80%),specificity of 78%(95%CI:75%-80%),and area under the curve(AUC)of 0.877 in identifying HCC from non-cancerous controls.Subgroup analysis showed that serum-based circRNA testing achieved an AUC of 0.929 better than tissue-(AUC=0.859)and plasma-based analyses(AUC=0.724).circRNA testing yielded the highest AUC of 0.929 in discriminating HCC from healthy individuals,but a low AUC of 0.730 in detecting chronic hepatitis and liver cirrhosis;up-regulated circRNA signature showed a larger AUC than down-regulated circRNA profiling(AUC:0.863 vs 0.836);circRNA signature harbored higher efficacy in Asians than that in Africans(AUC:0.929 vs 0.854).Additionally,distinct diagnostic efficacy was also observed in the analyses based on different reference genes.Conclusion The results indicated that circRNA may be developed as additional biomarker(s)for HCC detection.

关 键 词：circRNA 肝细胞癌 诊断 META分析 

分 类 号：R735.7[医药卫生—肿瘤]