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Meta-Analysis
. 2019 Jul;7(7):e00749.
doi: 10.1002/mgg3.749. Epub 2019 May 20.

Diagnostic performance of circular RNAs in human cancers: A systematic review and meta-analysis

Juan Li  1   2 , Hang Li  1   2 , Xiaoting Lv  1   2 , Zitai Yang  1   2 , Min Gao  1   2 , Yanhong Bi  1   2 , Ziwei Zhang  1   2 , Shengli Wang  1   2 , Zhigang Cui  3 , Baosen Zhou  1   2 , Zhihua Yin  1   2
Affiliations
Meta-Analysis

Diagnostic performance of circular RNAs in human cancers: A systematic review and meta-analysis

Juan Li et al. Mol Genet Genomic Med. 2019 Jul.

Abstract

Background: Recently, accumulating evidence have revealed that circular RNA (circRNA) was deregulated in multiple types of cancer, suggesting that circRNA might serve as a novel candidate biomarker of cancer diagnosis. However, inconsistent results have become an obstacle in applying circRNAs to clinical practice. The aim of this study is to evaluate diagnostic value of circRNAs among cancers.

Methods: A literature search was systematically performed among PubMed, Sciencedirect, Cochrane Library, Web of Science, Wanfang, and Chinese National Knowledge Infrastructure databases up to February 15, 2019. The pooled sensitivity (SEN), specificity (SPE), positive likelihood ratios, negative likelihood ratios, diagnostic odds ratio, and area under the SROC curve (AUC) were applied to evaluate diagnostic performance of circRNAs.

Results: In total, the study included 64 studies with single circRNA and 13 studies with combined circRNAs. Overall, the study presented that a single circRNA had moderate diagnostic value, with a SEN of 0.75, a SPE of 0.76, and an AUC of 0.82. The plasma circRNAs had higher diagnostic accuracy than tissue (AUC: 0.87, 95% confidence interval [CI]: 0.83-0.89 for plasma/serum subgroup; AUC: 0.79, 95% CI: 0.75-0.82 for tissue subgroup). Furthermore, the combined circRNAs had good diagnostic efficacy for GC, with a SEN of 0.89, a SPE of 0.94, and an AUC of 0.97, respectively.

Conclusion: This study confirmed that circRNAs may be candidate biomarkers for cancer diagnosis. In particular, diagnosis of combined circRNAs will be a new alternative applied to clinical research and practice for cancer.

Keywords: CircRNA; biomarker; cancer; diagnosis.

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Conflict of interest statement

No conflicts of interest proclaimed.

Figures

Figure 1
Figure 1
The flow diagram of this meta‐analysis
Figure 2
Figure 2
The diagnostic accuracy index of circRNA. (a) Sensitivity, (b) Specificity. circRNA, circular RNA
Figure 3
Figure 3
Evaluation of the diagnostic accuracy of circRNA. (a) Fagan's nomogram, (b) ROC Plane, (c) Meta‐regression analysis, d SROC curve, (e) Bivariate boxplot, f Deeks’ funnel plot. circRNA, circular RNA; ROC, receiver operating characteristics; SROC, summary receiver operator characteristic
Figure 4
Figure 4
The SROC curve of circRNA in different cancers. (a) BC, (b) GC, (c) HCC in plasma/serum group. (d) CRC, (e) GC, (f) HCC in tissue group. BC, breast cancer; CRC, colorectal cancer; GC, gastric cancer; HCC, hepatocellular carcinoma; SROC, summary receiver operator characteristic
Figure 5
Figure 5
Evaluation of the diagnostic accuracy of the combined circRNA. (a) Sensitivity, (b) Specificity, (c) ROC Plane, (d) Fagan's nomogram, (e) SROC curve, (f) Bivariate boxplot, (g) Deeks’ funnel plot. circRNA, circular RNA; ROC, receiver operating characteristics; SROC, summary receiver operator characteristic
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