循环长链非编码RNA作为生物标记物用于结直肠癌诊断的meta分析  

Circulating long noncoding RNAs as potential diagnostic markers for detecting colorectal cancer:A meta-analysis

作　　者：江梅[1] 万腊根[1] 万劲华 聂益军[1] 刘淑媛[1] 吕小林[1] 张长林[1] JIANG Mei;WAN Lagen;WAN Jinhua;NIE Yijun;LIU shuyuan;LV Xiaolin;ZHANG Zhanglin(The Clinical Laboratory of the First Affiliated Hospital of Nanchang University,Nanchang 330006,China.)

机构地区：[1]南昌大学第一附属医院检验科,江西南昌330006

出　　处：《实验与检验医学》2020年第6期1047-1052,1059,共7页Experimental and Laboratory Medicine

基　　金：江西省应用研究培育计划项目,编号20181BBG78057;江西省卫生计生委科技计划项目,编号20165168;江西省教育厅科学技术研究项目,编号GJJ150127。

摘　　要：目的近年来多项研究结果表明许多长链非编码RNA(long noncoding RNA,lncRNA)可作为生物标记物用于结直肠癌的诊断。但是它们的诊断效能并不完全一致。本研究利用Meta分析的方法,对lncRNA在结直肠癌中的诊断价值进行系统性评价。方法数据库中检索发表的有关循环中lncRNA作为肿瘤标记物用于结直肠癌诊断的研究。根据纳入与排除标准进行文献筛选,利用QUADAS-2(Quality Assessment of Diagnostic Accuracy Studies)对文献进行质量评价。使用双变量随机效应模型合并灵敏度(SEN)、特异度(SPE)、阳性似然比(PLR)、阴性似然比(NLR)、诊断比值比(DOR)。总体的受试者工作特征曲线下面积(AUC)和受试者工作特征曲线(SROC)用于总体诊断效能评价。使用Cochran’s Q检验和I 2(inconsistency index)检验进行异质性分析。亚组分析和Meta回归用于分析异质性原因。结果根据纳入与排除标准,最终纳入9篇文献,包括833例结直肠癌患者和688例对照。循环lncRNA诊断结直肠癌的合并灵敏度,特异度,阳性拟然比,阴性拟然比,诊断比值比分别为0.77(95%CI:0.72~0.81),0.83(95%CI:0.76~0.88),4.5(95%CI:3.2~6.4),0.28(95%CI:0.22~0.35),16(95%CI:9~27)。曲线下面积为0.86(95%CI:0.83~0.89)。另外,根据样本量、种族、lncRNA研究模式、样本类型做亚组分析,结果显示异质性主要来源于样本量以及样本类型,样本量≤60组的特异度优于样本量>60组(0.87vs0.81),样本类型为血浆组的灵敏度优于血清组(0.79vs0.74)。结论循环lncRNA对结直肠癌具有较高的诊断价值,可作为结直肠癌诊断的生物标记物。Objective Several studies have demonstrated that various long noncoding RNAs(lncRNAs)can be used as potential circulating diagnostic biomarkers for colorectal cancer(CRC).However,reports on their diagnostic accuracy are inconsistent.Thus,the present meta-analysis comprehensively evaluated the diagnostic value of circulating lncRNAs for detecting CRC.Methods A web-based literature search was performed to identify eligible studies of circulating lncRNAs for detecting CRC.Then,study quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool.Sensitivity,specificity,positive and negative likelihood ratios,and diagnostic odds ratios were pooled using bivariate random effects models.Summary receiver operating characteristic curves and the area under the curve were calculated to assess overall diagnostic performance.Heterogeneity was evaluated by Cochran’s Q-test and the inconsistency index(I2).Subgroup and meta-regression analyses were also performed to explore potential sources of significant heterogeneity.Results Nine articles comprised of 833 CRC patients and 688 controls were included in the current meta-analysis.The pooled sensitivity,specificity,positive and negative likelihood ratios,and diagnostic odds ratios of lncRNAs used for the diagnosis of CRC were 0.77[95%confidence interval(CI):0.72~0.81],0.83(95%CI:0.76~0.88),4.5(95%CI:3.2~6.4),0.28(95%CI:0.22~0.35),and 16(95%CI:9~27),respectively.The area under the summary receiver operating characteristic curve was 0.86(95%CI:0.83~0.89).Subgroup analysis revealed that heterogeneity in reporting originated from sample size and specimen.Studies with 60 subjects or less had better specificity than those with more than 60 subjects(0.87 versus 0.81),and plasma-based lncRNAs had better sensitivity than serum-based(0.79 versus 0.74).Conclusions Circulating lncRNAs may be potential diagnostic markers with relatively good performance for detecting CRC.Further large-scale studies with larger sample sizes examining a variety of specimens are require

关 键 词：长链非编码RNA 诊断 结直肠癌 

分 类 号：R446[医药卫生—诊断学] R735.3[医药卫生—临床医学]