Diagnostic Value Of Serum,Plasma And Sputum MiRNA-21 In Lung Cancer:A Meta-analysis

Background and Objective:Lung cancer is the most common malignancy.Its morbidity and mortality are increasing year by year,and it has seriously threatened human health.Because of its atypical early symptoms,low specificity of relevant imaging examinations and poor sensitivity of histological examinations,many patients are in advanced stages when diagnosed with lung cancer,resulting in a very poor prognosis.Therefore,it is important to develop non-invasive,low-cost,easy-to-promote screening methods and achieve early diagnosis of lung cancer.The purpose of this study is to use a meta-analysis of clinical trials to evaluate the accuracy of serum,plasma and sputum miRNA-21 in the diagnosis of lung cancer.Methods:The databases of Embase,Cochrane Library,PubMed,Wanfangdata,CNKI,SinoMed,VIP were searched since the establishment to collect published studies that diagnosed lung cancer by serum,plasma and sputum miRNA-21.The languages were limited to English and Chinese.Screening of literature requires inclusion criteria,exclusion criteria and literature quality.Use Stata(Stata Corporation,College Station,TX,USA,version 14.0)and MetaDiSc(version 1.4)to draw forest plots and SROC curves,summarize the sensitivity(SEN),specificity(SPE)and diagnostic odds ratio(DOR),calculate the area under the SROC curve(AUC).Identify heterogeneity between studies.Use sensitivity analysis,meta regression and subgroup analysis to analyze sources of heterogeneity.To assess publication bias,Deek’s funnel plots were plotted.Draw Fagan’s nomograms to evaluate clinical significance.The Z-test was used to compare the AUC values and the corresponding Q index of miRNA-21 diagnosed lung cancer in three different samples.Results:1.Finally,17 literatures of diagnostic value of serum miRNA-21 in lung cancer were used for this meta-analysis.The pooled SEN was 0.69(95%CI: 0.67-0.72),the SPE was 0.77(95%CI: 0.74-0.79),the pooled DOR was 9.70(95%CI: 6.58-14.29)and the AUC value was 0.8284.2.Finally,15 literatures of diagnostic value of plasma miRNA-21 in lung cancer were used for this meta-analysis.The pooled SEN was 0.70(95%CI: 0.68-0.73),the SPE was 0.76(95%CI: 0.73-0.79),the pooled DOR was 8.08(95%CI: 5.41-12.05)and the AUC value was 0.7908.3.Finally,5 literatures of diagnostic value of sputum miRNA-21 in lung cancer were used for this meta-analysis.One article was removed after heterogeneity testing.The pooled SEN was 0.73(95%CI: 0.65-0.80),the SPE was 0.77(95%CI: 0.71-0.82),the pooled DOR was 8.85(95%CI: 5.42-14.47)and the AUC value was 0.8263.4.The Z-test was used to compare the AUC and Q indexes of the three samples,and the results showed that there was no statistical difference in the diagnostic value of miRNA-21 in the three samples.Conclusions:1.The meta-analysis was used to evaluate the diagnostic value of miRNA-21 in serum,plasma and sputum in lung cancer.All three can be used as new biomarkers for lung cancer diagnosis.2.There was no statistical difference in the diagnostic value of miRNA-21 in the three samples for lung cancer.