目的 评价循环microRNAs在食管癌检测中的诊断价值及精度.方法 在英文数据库(Embase、Pubmed、Cochrane)和中文数据库(知网、万方、维普)自建库至2022年4月21日的相关研究进行系统性的文献检索.使用OpenMetaAnalyst以及RevMan5.3软件包的统计学分析.采用双变量随机效应模型(bivariate random-effects model,BRM),对总体miRNA检测性能进行综合评估,包括敏感性和特异性等参数的分析.采用亚组分析方法对异质性进行评估,同时运用敏感性分析对本研究的分析进行稳健性评估,并结合Deeks漏斗图不对称检验对所选研究的发表偏倚进行评估.结果 共有10篇文章含15项研究纳入本研究,其中食管癌995例,对照组612例.总体敏感性和特异性分别为0.838(95%CI:0.782~0.882)和0.780(95%CI:0.691~0.848).总体诊断比值比(diagnostic odds ratio,DOR)、阳性似然比(positive likelihood ratio,PLR)、阴性似然 比(negative likelihood ratio,NLR)分别为 22.532(95%CI:12.237~41.487)、3.598(95%CI:2.622~4.937)和 0.185(95%CI:0.121~0.283).根据研究设计及miRNA谱对亚组进行分析,发现多个miRNA面板在检测食管癌方面更准确,联合DOR为30.428(95%CI:8.58~105.37).结论 循环microRNAs可作为食管癌诊断的一种无创的生物标志物,多个microRNAs盒联用有望成为临床上筛查的工具.
Objective To evaluate the diagnostic accuracy of circulating microRNAs in the detection of esophageal cancer.Methods A systematic literature search was conducted on relevant studies in English databases(Embase,Pubmed,Cochrane)and Chinese databases(CNKI,Wanfang,Weipu)until April 21,2022.OpenMetaAnalyst and RevMan5.3 software packages were used for statistical analysis.A bivariate ran-dom effects model(BRM)was used to comprehensively evaluate the overall microRNAs detection perform-ance,including the analysis of sensitivity and specificity parameters.Subgroup analysis was used to evaluate the heterogeneity,and sensitivity analysis was used to evaluate the robustness of the analysis.The Deeks fun-nel plot asymmetry test was used to evaluate the publication bias of the selected studies.Results 10 articles including 15 studies were included in this study,including 995 cases of esophageal cancer and 612 cases in the control group.The overall sensitivity and specificity were 0.838(95%CI:0.782~0.882)and 0.780(95%CI:0.691~0.848),respectively.The overall diagnostic odds ratio(DOR),positive likelihood ratio(PLR),and negative likelihood ratio(NLR)were 22.532(95%CI:12.237-41.487),3.598(95%CI:2.622-4.937),and 0.185(95%CI:0.121-0.283),respectively.According to the re-search design and microRNAs spectrum analysis of subgroups,it was found that multiple microRNAs panels were more accurate in detecting esophageal cancer,with a combined DOR of 30.428(95%CI:8.58-105.37).Conclusion Circulating microRNAs may serve as non-invasive detection biomarkers in the diag-nosis of esophageal cancer.When multiple microRNAs kits can be used for clinical diagnosis,they may be-come a screening tool in clinical practice.