Meta-analysis Of The Diagnostic Value Of MicroRNAs Carried By Exosomes In Breast Cancer

Objective:Breast cancer is the most familiar malignant cancer in women in the world,and ranks first in the incidence and mortality of female malignant tumors in China.In order to find new biomarkers for breast cancer,this study systematically evaluated the diagnostic value of micro RNAs carried by exosomes for breast cancer by means of meta-analysis.Methods: "Pubmed","Embase","Cochrane Library","Web of Science","CNKI","Chinese Biomedical Literature","Wanfang","VIP" and other databases were searched by computer from the establishment Of the database to October 2020.Two researchers conducted literature search and screening,data extraction and quality evaluation.Stata16.0 software and Review Manager5.3 software were used to summarize and statistically analyze the data,combined with sensitivity,specificity,Positive Likelihood Ratio(PLR),Negative Likelihood Ratio(NLR),Diagnostic Odds Ratio(DOR),Summary Receiver Operating Characteristic Curves(SROC),Area Under the Curve(AUC),etc.,to conduct sensitivity analysis and determine publication bias.Then subgroup analysis was conducted to explore the source of heterogeneity according to the source of exosomes,race and number of study samples.Results: 1.Results of 17 studies included showed a sensitivity of 0.85(95%CI 0.77-0.91),specificity of 0.83(95%CI 0.78-0.88),PLR of 5.13(95%CI 3.64-7.23),NLR of 0.18(95%CI 0.11-0.29),DOR was 29.14(95%CI 13.35-63.61),AUC value was 0.90(95%CI 0.87-0.92),and P value of publication bias was 0.688(> 0.05).2.The results of subgroup analysis showed that in the age group(< 52 years old).The sensitivity,specificity and AUC of micro RNAs carried by exosomes in the diagnosis of breast cancer were 0.67,0.80 and 0.77,respectively.In age group(≥52 years old),the sensitivity,specificity and AUC were 0.87,0.85 and 0.92,respectively.3.When exosomes carried a single micro RNA,the sensitivity,specificity and AUC of the microRNAs carried by exosomes in the diagnosis of breast cancer were 0.83,0.80 and 0.83,respectively.When exosomes carry multiple micrornas,their sensitivity,specificity and AUC are 0.90,0.93 and 0.97,respectively.4.In yellow population,the sensitivity,specificity and AUC of micro RNAs carried by exosomes in diagnosing breast cancer were 0.83,0.83 and 0.88,respectively.The sensitivity,specificity and AUC were 0.81,0.93 and 0.94,respectively.The sensitivity,specificity and AUC were 0.90,0.78 and 0.92,respectively.5.For plasma derived exosomes,the sensitivity,specificity and AUC of micro RNAs carried in the diagnosis of breast cancer were 0.78,0.85 and 0.89,respectively.The sensitivity,specificity and AUC of serum-derived exosomes carrying micro RNAs in the diagnosis of breast cancer were 0.87,0.77 and 0.90,respectively.Conclusion: Through meta-analysis,it can be concluded that micro RNAscarried by exosomes have good diagnostic value for breast cancer and are expected to become biomarkers for breast cancer diagnosis in the future.The sensitivity and specificity of exosomes carrying multiple micro RNAs are better than that of single micro RNA.The sensitivity of plasma derived exosomes in the diagnosis of breast cancer is higher than that of serum derived exosomes,but the specificity of plasma derived exosomes is lower than that of serum derived exosomes...