外泌体miRNA诊断肝细胞癌价值的Meta分析  

Diagnostic value of exosomal miRNA for hepatocellular carcinoma:a meta-analysis

作　　者：郭秋霞 张胜勇 GUO Qiu-xia;ZHANG Sheng-yong(Public People’s Hospital of Xinzheng,Zhengzhou 451100,Henan,CHINA)

机构地区：[1]新郑市公立人民医院检验科,河南郑州451100

出　　处：《海南医学》2025年第8期1172-1179,共8页Hainan Medical Journal

基　　金：国家科技重大专项项目(编号:2018ZX10714002-003-005)。

摘　　要：目的系统评价外泌体微小核糖核酸(miRNA)对肝细胞癌(HCC)的临床诊断价值。方法检索PubMed、Embase、中国期刊全文数据库(CNKI)、万方数据库等自建库至2024年3月19日收录的相关文献,筛选外泌体miRNA对HCC诊断价值的临床研究。采用QUADAS-2工具评估文献质量,使用Stata12.0计算灵敏度(SEN)、特异度(SPE)、阳性似然比/阴性似然比(+LR/-LR)、诊断比值比(DOR)以及汇总受试者工作特征(SROC)曲线,绘制Fagan's列线图评估诊断效能,用漏斗图检测发表偏倚,采用亚组分析探究异质性来源。结果共计纳入17篇文献、21项研究,包括1084例病例组和1654例对照组,外泌体miRNA诊断HCC的灵敏度为0.89(95%CI:0.84~0.93),特异度为0.89(95%CI:0.83~0.93),阳性似然比为7.82(95%CI:5.17~11.84),阴性似然比为0.12(95%CI:0.08~0.19),诊断比值比为65.78(95%CI:34.07~127.01),SROC曲线下面积0.95(95%CI:0.93~0.97)。结论外泌体miRNA可作为HCC的潜在新型诊断标志物。但其临床应用受限于miRNA选择策略、组合优化及种族差异等因素,需通过多中心临床试验及标准化检测流程进一步验证。Objective To systematically evaluate the clinical diagnostic efficacy of exosomal miRNA in HCC by meta-analysis.Methods Relevant studies published from database inception to March 19,2024 were from PubMed,Embase,CNKI,WanFang,and other authoritative databases.The relevant literatures focusing on the diagnostic efficacy of exosomal miRNAs for HCC were screened.Study quality was assessed using the QUADAS-2 tool.Statistical analy-ses were performed with Stata 12.0 to calculate sensitivity(SEN),specificity(SPE),positive/negative likelihood ratios(+LR/-LR),diagnostic odds ratio(DOR),and the summary receiver operating characteristic(SROC)curve.Fagan’s nomo-gram was used to evaluate diagnostic utility,funnel plots assessed publication bias,and subgroup analyses explored het-erogeneity sources.Results Seventeen studies(21 datasets)involving 1084 HCC cases and 1654 controls were includ-ed.The pooled sensitivity and specificity of exosomal miRNAs for HCC diagnosis were 0.89(95%CI:0.84-0.93)and 0.89(95%CI:0.83-0.93),respectively.The positive likelihood ratio(+LR)was 7.82(95%CI:5.17-11.84),negative likeli-hood ratio(-LR)was 0.12(95%CI:0.08-0.19),and the diagnostic odds ratio(DOR)was 65.78(95%CI:34.07-127.01).The area under the SROC curve(AUC)was 0.95(95%CI:0.93-0.97).Conclusion Exosomal miRNAs show signifi-cant potential as novel diagnostic biomarkers for HCC.However,clinical application is currently limited by factors such as miRNA selection strategies,panel optimization,and ethnic heterogeneity.Further validation through multi-center clini-cal trials and standardized detection protocols is required to confirm their utility in routine practice.

关 键 词：MIRNA 外泌体 肝细胞癌 甲胎蛋白 诊断试验 META分析 系统评价 诊断价值 

分 类 号：R735.7[医药卫生—肿瘤]