MicroRNAs are novel non-invasive diagnostic biomarkers for pulmonary embolism: a meta-analysis

Abstract

Backgrounds: The diagnosis of pulmonary embolism (PE) still remains difficult in clinical practice. MicroRNAs (miRNAs) have been widely investigated as biomarkers for various diseases. However, the diagnostic biomarker value of miRNAs in the diagnosis of PE is unclear. Therefore, we conducted this meta-analysis to establish the diagnostic power of miRNAs for PE diagnosis.

Methods: A systematic literature search in PubMed and Embase was conducted to identify relevant studies dated up to July 22, 2016. Data on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were pooled from those included studies. Summary receiver operating characteristic (SROC) curves were used to summarize overall diagnostic power of miRNAs for PE diagnosis.

Results: A total of three studies with five types of miRNAs covering 254 participants were included in our meta-analysis. The overall pooled results for sensitivity, specificity, PLR, NLR, and DOR of miRNAs for PE diagnosis were 0.83 [95% confidence intervals (CI): 0.67-0.92], 0.85 (95% CI: 0.72-0.92), 5.4 (95% CI: 2.7-10.9), 0.20 (95% CI: 0.10-0.44), and 26.00 (95% CI: 7.00-101.00), respectively. The area under the SROC curve was 0.90 (95% CI: 0.87-0.92). Even though heterogeneity was observed in the analysis of sensitivity, there was no evidence of publication bias.

Conclusions: MiRNAs could serve as novel non-invasive diagnostic biomarkers of PE with a relatively high diagnostic power. More researches, however, are needed to explore the diagnostic as well as therapeutic values of miRNAs for PE.

Keywords: MicroRNA; diagnosis; meta-analysis; pulmonary embolism (PE).

Figure 1

Flow chart showing the progress of studies throughout the review. miRNAs, microRNAs.

Figure 2

Risk of bias analyses. (A) Risk of bias and applicability concerns graph: review authors’ judgements about each domain presented as percentages across included studies; (B) risk of bias and applicability concerns summary: review authors’ judgements about each domain for each included study.

Figure 3

Forest plots of the pooled: (A) sensitivity; (B) specificity of miRNAs in diagnosis of PE. PE, pulmonary embolism; miRNAs, microRNAs.

Figure 4

Summary ROC curve of overall analysis for the diagnostic power of miRNAs for PE diagnosis. PE, pulmonary embolism; miRNAs, microRNAs; ROC, receiver operating characteristic; SROC, summary receiver operating characteristic; AUC, area under the curve.

Figure 5

Deeks’ linear regression test of funnel plot asymmetry.