MicroRNA-21 as a Potential Biomarker for Colorectal Cancer Diagnosis: A Meta-analysis
Chao-Hui Zhen
Department of Hepatobiliary Surgery, The Second Clinical Medical College (Shenzhen People’s Hospital), Jinan University, Shenzhen, China
Guo-Jun Yao
Department of Gastroenterology, The Second Clinical Medical College (Shenzhen People’s Hospital), Jinan University, Shenzhen, China
Yan Tan
Department of Hepatobiliary Surgery, The Second Clinical Medical College (Shenzhen People’s Hospital), Jinan University, Shenzhen, China
Lu Yang
The Second Clinical Medical College (Shenzhen People’s Hospital), Jinan University, Shenzhen, China
Xiao-Fang Yu *
Department of Hepatobiliary Surgery, The Second Clinical Medical College (Shenzhen People’s Hospital), Jinan University, Shenzhen, China
Fu-Rong Li *
The Second Clinical Medical College (Shenzhen People’s Hospital), Jinan University, Shenzhen, China
*Author to whom correspondence should be addressed.
Abstract
Aims: Colorectal cancer (CRC) occupies an important position in the morbidity and mortality constitution of malignancies. In recent years, mounting literature has reported about the upregulating expression of microRNA-21 in blood and stool of CRC patients, which suggested that microRNA-21 may become a novel potential biomarker for CRC. Consequently, this meta-analysis was designed to systematically review the values of microRNA-21 in CRC diagnosis.
Methodology: Databases, including Cochrane library, PubMed, EMbase, Google Scholar, and Chinese National Knowledge Infrastructure, were scanned to retrieve relevant articles focusing on microRNA-21 in CRC diagnosis. Articles were then filtered according to the PRISMA statement and assessed by quality assessment of diagnosis accuracy studies-2. Sensitivity (SEN), specificity (SPE), positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) were pooled using fixed-effects model or random-effects model. Summary receiver operating characteristic (SROC) curve and area under the curve (AUC) were used to estimate the overall diagnostic performance.
Results: A total of 15 studies, comprising 1268 CRC patients and 910 healthy controls, were enrolled in this meta-analysis. For serum miR-21, the pooled DOR, SEN, and SPE were 13.97 (95% CI: 8.44–23.11), 0.73 (95% CI: 0.69–0.77), and 0.83 (95% CI: 0.76–0.89), respectively; for plasma miR-21, the pooled DOR, SEN, and SPE were 8.03 (95% CI: 3.30–19.52), 0.67 (95% CI: 0.60–0.73), and 0.76 (95% CI: 0.69–0.81), respectively; and for fecal miR-21, the pooled DOR, SEN, and SPE were 7.06 (95% CI: 2.17–22.95), 0.33 (95% CI: 0.28–0.37), and 0.91 (95% CI: 0.88–0.93), respectively. Moreover, the AUC values of serum, plasma, and fecal miR-21 in CRC diagnosis were 0.8701, 0.8295, and 0.6742, respectively.
Conclusion: Blood miR-21 demonstrates good diagnostic performance, and serum samples are better than plasma samples in CRC diagnosis. For fecal miR-21, the sensitivity is unsatisfactory, but the specificity is favorable in predicting CRC patients.
Keywords: MicroRNA-21, diagnosis, colorectal cancer, meta-analysis.