| Objective:Collecting the related researches on the diagnosis of microRNA for digestive system tumors and using the method of Meta-analysis to systematically evaluate the diagnostic efficiency of microRNA in the digestive system tumors,and providing reference for clinical practice and application.Methods:Retrieval literatures about the diagnostic value of microRNA as a biomarker for gastric cancer or liver cancer or esophageal cancer or colorectal cancer or cholangiocarcinoma.The literatures were screened according to the pre-established inclusion and exclusion criteria,then the quality evaluation and data extraction were carried out.Stata 12.0 and Meta-Di Sc 1.4 software were used to analyze the extracted data.The analysis indexes include the sensitivity(SEN),the specificity(SPE),the positive likelihood ratio(PLR),the negative likelihood ratio(NLR),the diagnostic ratio ratio(DOR)and the area under the summary receiver operator characteristic curve(AUC).According to the results of heterogeneity test,select the appropriate model to combine the effect size.A subgroup analysis was conducted based on sample type,inclusion status in the population,the health status of the control group,and single or combined application of microRNA.Draw the Deek ’s funnel plot to determine whether publication bias exists in the study.Using the Fagan’s nomogram to evaluate the PLR and NLR for prior probability and posterior probability after the application of microRNA.Results:1.A total of 32 articles were included in the Meta-analysis of the diagnostic value of microRNA for gastric cancer,including 2342 patients and 2322 controls.The pooled SEN of microRNA for the diagnosis of gastric cancer was 0.77(95% CI:0.76,0.79),SPE was 0.83(95% CI:0.81,0.84),PLR was 4.53(95% CI:3.81,5.38),and NLR was CI: 0.2.3,0.30).The pooled DOR was 19.99(95% CI:15.78,25.32),and AUC was 0.8832.The AUC value of serum microRNA in diagnosing gastric cancer was 0.9052,and the AUC value of microRNA in plasma was 0.8726.2.A total of 17 articles were included in the Meta-analysis of the diagnostic value of microRNA for hepatocellular carcinoma,including 1628 patients and 1744 controls.The pooled SEN of microRNA for the diagnosis of liver cancer was 0.81(95% CI:0.80,0.83),SPE was 0.83(95% CI:0.81,0.84),PLR was 4.60(95% CI:3.84,5.51),and NLR was 0.22(95% CI:0.18,0.27).The pooled DOR was 23.58(CI:17.16)and AUC was 0.8991.The AUC value of serum microRNA in diagnosing liver cancer was 0.9071,and the AUC value of microRNA in plasma was 0.8384.3.A total of 15 articles were included in the Meta-analysis of the diagnostic value of microRNA for esophageal cancer,including 1556 patients and 1497 controls.The pooled SEN of microRNA for the diagnosis of esophageal cancer was 0.79(95% CI:0.77,0.81),SPE was 0.83(95% CI:0.81,0.85),PLR was 4.33(95% CI:3.34,5.61),and NLR was 0.26(95% CI:0.21,0.33).The pooled DOR was 19.41(95% CI: 12.62,29.83),and AUC was 0.8774.The AUC value of serum microRNA in diagnosing esophageal cancer was 0.8625,and the AUC value of microRNA in plasma was 0.6821.4.A total of 45 articles were included in the Meta-analysis of the diagnostic value of microRNA for colorectal cancer,including 3883 patients and 2791 controls.The pooled SEN of microRNA for the diagnosis of colorectal cancer was 0.76(95% CI:0.75,0.77),SPE was 0.79(95% CI:0.78,0.80),PLR was 3.77(95% CI:3.33,4.28),and NLR was 0.27(95% CI:0.24,0.31).The pooled DOR was 15.27(95% CI:12.28,18.99),and AUC was 0.8664.The AUC value of serum microRNA in diagnosing colorectal cancer was 0.8708,and the AUC value of microRNA in plasma was 0.8652.5.A total of 9 articles were included in the Meta-analysis of the diagnostic value of microRNA for cholangiocarcinoma,including 513 patients and 471 controls.The pooled SEN of microRNA for the diagnosis of cholangiocarcinoma was 0.75(95% CI:0.72,0.78),SPE was 0.84(95% CI:0.81,0.87),PLR was 4.13(95% CI:3.08,5.54),and NLR was 0.31(95% CI:0.23,0.41).The pooled DOR was 17.00(95% CI:10.70,27.00),and the AUC was 0.8762.The AUC value of serum microRNA in diagnosing esophageal cancer was 0.9022,and the AUC value of microRNA in urine was 0.7548.Conclusions:1.For the first time,the meta-analysis was used to identify that the microRNA in body fluids had a high diagnostic value for gastric cancer,liver cancer,esophageal cancer,colorectal cancer,and cholangiocarcinoma.MicroRNA could be used as a biomarker for early diagnosis of the five digestive system tumors;2.The diagnostic efficacy of microRNA in differentiating gastric cancer patients from healthy controls was higher than that in patients with gastric cancer and benign gastropathy;3.In patients with hepatocellular carcinoma,the diagnostic efficacy of serum microRNA is superior to that in plasma;in patients with cholangiocarcinoma,the diagnostic efficacy of serum microRNA is better than that of microRNA in urine;4.The diagnostic efficacy of microRNA on colorectal cancer in the United States is better than that in other countries;5.In the diagnosis of colorectal cancer,the diagnostic efficacy of the combined use of microRNA is superior to a single application. |
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