Identification of microRNAs as novel biomarkers for detecting esophageal squamous cell carcinoma in Asians: a meta-analysis

Abstract

Accumulating evidence has suggested that microRNAs (miRNAs) may play potential role as ideal diagnostic indicators of esophageal squamous cell carcinoma (ESCC). However, previous studies have met discrepant results. Thus, we conducted this meta-analysis to assess the potential diagnostic value of miRNAs for ESCC. A systematic literature search was conducted in PubMed and other databases. The pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to evaluate the overall test performance. The Q statistic and the I(2) test were used to assess between-study heterogeneity. The potential sources of heterogeneity were further analyzed by subgroup analyses and meta-regression. Seventeen studies from eight articles, including 995 ESCC patients and 733 healthy controls, were included in this meta-analysis. The pooled SEN and SPE were 0.81 (95% confidence interval (CI) 0.76-0.85) and 0.83 (95 % CI 0.76-0.88), respectively. The pooled PLR was 4.6 (95% CI 3.3-6.5), NLR was 0.23 (95% CI 0.19-0.29), and DOR was 20 (95% CI 13-31). The pooled AUC was 0.91 (95% CI 0.88-0.93). Subgroup analyses indicated that blood-based miRNA assay displays better diagnostic accuracy than saliva-based miRNA assay. In summary, miRNA analysis may serve as novel noninvasive biomarkers for ESCC with excellent diagnostic characteristic. In addition, subgroup analysis suggested that blood-based assay yields better diagnostic characteristics than saliva-based assay. However, many issues should be managed before these findings can be translated into a clinically useful detection method for ESCC.

Circulating miRNAs as novel potential biomarkers for esophageal squamous cell carcinoma diagnosis: a meta-analysis update

“…27 Our present meta-analysis also showed the similar results and verified that blood miRNAs had a relatively high diagnostic accuracy. More importantly, the advantages of our meta-analysis are as follows: first, this study was much larger, with more than twice as many studies as the earlier meta-analysis.…”

“…50,51 This pooled method is different from a previous meta-analysis of circulating miRNAs in the diagnosis of ESCC, which treated the discovery and validation groups as one single group. 27 If these two groups are not independent, sum of samples size may lead to a population overlapping bias. Our combined studies approach should increase the accuracy statistics from the meta-analysis.…”

“…Recently, Wang et al carried out a meta-analysis and reported that blood-based miRNA assays yield better diagnostic characteristics than saliva-based assays for ESCC. 27 Indeed, the detected blood-based candidate miRNAs were considerably different because the profiles of cancer-associated miRNAs might be different between plasma and serum. 28,29 Moreover, there are more sensitive plasma miRNA biomarkers that have been identified by different methods such as next-generation sequencing or miRNAarray-based approaches.…”

From blood to breath: New horizons for esophageal cancer biomarkers

“…A review by Wang et al[45] of eight manuscripts investigated a total of 16 different types of miRNAs in serum and saliva of Asian esophageal squamous cell carcinoma patients. The authors reported relatively high sensitivity and specificity values for combination and single miRNA markers, suggesting some diagnostic application[45].…”

“…The authors reported relatively high sensitivity and specificity values for combination and single miRNA markers, suggesting some diagnostic application[45]. The prognostic utility of miRNAs have also been reviewed, with Fu et al[46] reporting on 39 potentially prognostic miRNAs in 25 individual studies.…”