Circulating miRNAs as Auxiliary Diagnostic Biomarkers for Multiple Myeloma: A Systematic Review, Meta-Analysis, and Recommendations

Abstract

Multiple myeloma (MM) is a hematologic malignancy characterized by aberrant expansion of monoclonal plasma cells with high mortality and severe complications due to the lack of early diagnosis and timely treatment. Circulating miRNAs have shown potential in the diagnosis of MM with inconsistent results, which remains to be fully assessed. Here we updated a meta-analysis with relative studies and essays published in English before Jan 31, 2021. After steps of screening, 32 studies from 11 articles that included a total of 627 MM patients and 314 healthy controls were collected. All data were analyzed by REVMAN 5.3 and Stata MP 16, and the quality of included literatures was estimated by Diagnostic Accuracy Study 2 (QUADAS-2). The pooled area under the curve (AUC) shown in summary receiver operating characteristic (SROC) analyses of circulating miRNAs was 0.87 (95%CI, 0.81–0.89), and the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were 0.79, 0.86, 5, 0.27, 22, respectively. Meta-regression and subgroup analysis exhibited that “miRNA cluster”, patient “detailed stage or Ig isotype” accounted for a considerable proportion of heterogeneity, revealing the importance of study design and patient inclusion in diagnostic trials; thus standardized recommendations were proposed for further studies. In addition, the performance of the circulating miRNAs included in MM prognosis and treatment response prediction was summarized, indicating that they could serve as valuable biomarkers, which would expand their clinical application greatly.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=234297, PROSPERO, identifier (CRD42021234297).

miRNAs and Multiple Myeloma: Focus on the Pathogenesis, Prognosis, and Drug Resistance

“…Several studies have shown that miRNAs are present in peripheral blood and can be biomarkers for various diseases. 125,126 For example, in a study by Xiang et al, researchers investigated the expression levels of miRNAs in the peripheral blood of patients with MM. They found that specific miRNAs were differentially expressed in MM patients compared to healthy controls, suggesting their potential as diagnostic biomarkers.…”

“…They found that specific miRNAs were differentially expressed in MM patients compared to healthy controls, suggesting their potential as diagnostic biomarkers. 125…”

Implication of microRNAs in Carcinogenesis with Emphasis on Hematological Malignancies and Clinical Translation

“…In MM, miR-4254 was found to be the most promising diagnostic biomarker [ 115 ]. In addition, a combination of up-regulated miR-34a and down-regulated let-7e could distinguish MM from both control and monoclonal gammopathy of undetermined significance (MGUS) with high sensitivity and specificity [ 116 ].…”