Background MicroRNA-21 (miR-21) is significantly expressed in a variety of cancers and could be used as a tumor biomarker. However, the results are varied, and no studies on the diagnostic usefulness of miR-21 in Asian esophageal cancer (EC) patients have been published. This meta-analysis was aimed at exploring whether miR-21 can be used as a diagnostic marker and assessing its effectiveness. Methods The relevant literature was identified in six main databases: Ovid MEDLINE, PsycINFO, PubMed MEDLINE, Embase, Web of Science, and the Cochrane Library. Two researchers independently selected the literature based on the inclusion and exclusion criteria, extracted data, and evaluated the risk of bias. The meta-analysis was carried out using Review Manager 5.4, Meta-Disc 1.4 and STATA 15.1 software. In the end, 987 patients from 12 different studies were included. Quality evaluation of diagnostic accuracy studies 2 (QUADAS—2) was used to examine the risk of bias. Results The pooled sensitivity (SEN) was 0.72 (95% CI [0.69–0.75]), the pooled specificity (SPE) was 0.78 (95% CI [0.75–0.81]), the pooled positive likelihood ratio (PLR) was 2.87 (95% CI [2.28–3.59]), the pooled negative likelihood ratio (NLR) was 0.36 (95% CI [0.31–0.43]), the pooled diagnostic odds ratio (DOR) was 10.00 (95% CI [7.73–12.95]), and the area under the curve 0.82 (95% CI [0.79–0.85]). A Deeks’ funnel plot shows that there was no publication bias (P = 0.99). Conclusion Our findings suggest miR-21 might be the potential biomarker for detecting EC in Asian populations, with a good diagnostic value.
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