| Background:Oral squamous cell carcinoma(OSCC)is characterized by high incidence,local invasiveness,high recurrence and easy metastasis,which means poor prognosis.At present,the main method to diagnose oral squamous cell carcinoma is histological biopsy.Although the accuracy and sensitivity of biopsy are extremely high,this method is invasive,so it is difficult to carry out this biopsy in the early diagnosis of oral squamous cell carcinoma.Therefore,it is of great significance to explore biomarkers with high accuracy and less invasiveness for improving the survival rate of patients with oral squamous cell carcinoma.At present,researches show that circular RNA is abnormally expressed in cancer.Compared with traditional biomarkers,circular RNA have relatively high sensitivity and specificity for diagnosing numerous malignancies such as liver cancer,stomach cancer,lung cancer,rectal cancer.Circular RNA is abundant in expression,stable and specific,so it may play an important role in maintaining the normal function of human body,and it may become an ideal biomarker for the diagnosis of oral squamous cell carcinoma.In this study,systematic review and evidence-based medicine were used to systematically evaluate the diagnostic value of circular RNA in oral squamous cell carcinoma.Methods : Two researchers independently searched 4 English databases including Pub Med,Web of Science,Cochrane and EMBASE,and the search time was set from the establishment of the database to March2021.In strict accordance with the inclusion criteria and exclusion criteria,selected the literatures which meet the requirements,extracted the data,including the first author,the year of publication,the country of origin,the degree of circ RNA expression,the source of the specimen,sensitivity(SEN),specificity(SPE),the area under the curve(AUC),true positive(TP),false positive(FP),false negative(FN),true negative(TN),the number of cases,the number of controls,and the diagnostic cut-off value(Cut-off value)of circular RNA.QUADAS-2system was used to analyze and evaluate the quality of the included documents,and stata15.0,metadisc1.4 and review manger5.3 software were used to systematically analyze the collected data.Results:A total of 6 studies were finally meta-analyzed,including335 patients and 409 controls.The six studies examined seven circ RNAs,five derived from tumor tissue from OSCC patients and two from OSCC patient salivary.When circ RNA is used as a diagnostic tool for OSCC,the pooled sensitivity,specificity,PLR,NLR,DOR and 95% CI for circ RNA diagnosing OSCC were 0.72(95% CI: 0.67–0.76),0.81(95%CI: 0.76–0.85),3.82(95% CI: 2.98–4.91),0.35(95% CI: 0.29-0.41),11.02(95% CI:7.89–15.40)respectively,and the AUC was 0.76(95% CI: 0.72–0.79).The DOR of saliva-derived circ RNA and tumor tissue-derived was 17.52(95%CI: 10.11-30.35),8.47(95%CI: 5.6-12.83)respectively.It indicated that circular RNA has high diagnostic value for oral squamous cell carcinoma.Subgroup analysis suggested that the diagnostic performance of saliva samples was higher than that of tumor tissue.The prior probability of the Fagan map is set to 20%,and the post-test probability becomes 49%and 8%,suggesting that circ RNA has high accuracy in the diagnosis of OSCC and great clinical effectiveness.The P value of Deeks’ funnel chart is 0.19(> 0.05),suggesting that there is no publication bias in the included study.Conclusion : Circular RNA is a potential biomarker for clinical diagnosis of oral squamous cell carcinoma. |
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