Diagnostic value of circulating lncRNAs as biomarkers of digestive system cancers: A systematic review and meta-analysis

This meta-analysis aims to explore the diagnostic value and accuracy of circulating lncRNAs as biomarkers of digestive system tumors. PubMed, Embase, Cochrane Library, and Web of science were searched for relevant articles that were published before April 2019, and a meta-analysis was conducted. 52 studies with 63 lncRNAs were discussed in the meta-analysis. The pooled sensitivity and specificity of diagnosis were 0.80 (95% CI: 0.79–0.81) and 0.76 (95% CI: 0.75–0.77), respectively. The pooled DOR (the diagnostic odds ratio) was 15.63 (95% CI: 12.77–19.12), and the overall AUC (the area under the curve) was 0.87. Besides, subgroup analyzes showed that the DOR and AUC of large sample sizes (>80), multiple lncRNAs, serum-based lncRNAs, and downregulation group were superior to those of small sample sizes (≤80), single lncRNA, plasma-based lncRNAs, and upregulation group, respectively. The current data also highlight that the diagnostic accuracy of circulating lncRNAs in the case of colorectal cancer was higher than gastric cancer, hepatocellular carcinoma, esophageal carcinoma, and pancreatic cancer. And there is no difference in the perspective of geographical regions. The circulating lncRNAs have high diagnostic value and accuracy in digestive system cancers and may serve as potential biomarkers.

本项荟萃分析旨在探讨循环长链非编码RNA（circulating lncRNAs）作为消化系统肿瘤生物标志物的诊断价值与诊断效能。本研究检索了2019年4月之前发表于PubMed、Embase、Cochrane图书馆及Web of Science的相关文献，并开展荟萃分析。本次荟萃分析共纳入52项研究，涉及63种循环长链非编码RNA。合并诊断灵敏度为0.80（95%置信区间：0.79~0.81），合并诊断特异度为0.76（95%置信区间：0.75~0.77）；合并诊断比值比（diagnostic odds ratio, DOR）为15.63（95%置信区间：12.77~19.12），整体受试者工作特征曲线下面积（area under the curve, AUC）为0.87。此外，亚组分析结果显示：样本量>80的研究、多lncRNAs检测、血清来源的循环长链非编码RNA以及表达下调组的诊断比值比和曲线下面积，均分别优于样本量≤80的研究、单lncRNAs检测、血浆来源的循环长链非编码RNA以及表达上调组。本研究数据同时表明，循环长链非编码RNA对结直肠癌的诊断效能高于胃癌、肝细胞癌、食管癌及胰腺癌，且不同地理区域间的诊断效能无显著差异。循环长链非编码RNA在消化系统恶性肿瘤中具有较高的诊断价值与效能，有望成为潜在的肿瘤生物标志物。