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. 2022 Nov 7:9:915226.
doi: 10.3389/fmed.2022.915226. eCollection 2022.

MicroRNA panels as diagnostic biomarkers for colorectal cancer: A systematic review and meta-analysis

Daniel Sur  1   2 , Shailesh Advani  3   4 , Dejana Braithwaite  5   6   7
Affiliations

MicroRNA panels as diagnostic biomarkers for colorectal cancer: A systematic review and meta-analysis

Daniel Sur et al. Front Med (Lausanne). .

Abstract

Background: Circulating microRNAs (miRNA) have emerged as promising diagnostic biomarkers for several diseases, including cancer. However, the diagnostic accuracy of miRNA panels in colorectal cancer (CRC) remains inconsistent and there is still lack of meta-analyses to determine whether miRNA panels can serve as robust biomarkers for CRC diagnosis.

Methods: This study performed a systematic review and meta-analysis to evaluate the clinical utility of miRNA panels as potential biomarkers for the diagnosis of CRC. The investigation systematically searched PubMed, Medline, Web of Science, Cochrane Library, and Google Scholar (21-year span, between 2000 and 2021) to retrieve articles reporting the diagnostic role of miRNA panels in detecting CRC. Diagnostic meta-analysis of miRNA panels used diverse evaluation indicators, including sensitivity, specificity, Positive Likelihood Ratio (PLR), Negative Likelihood Ratio (NLR), Diagnostic Odds Ratio (DOR), and the area under the curve (AUC) values.

Results: Among the 313 articles identified, 20 studies met the inclusion criteria. The pooled estimates of miRNA panels for the diagnosis of CRC were 0.85 (95% CI: 0.84-0.86), 0.79 (95% CI: 0.78-0.80), 4.06 (95% CI: 3.89-4.23), 0.20 (95% CI: 0.19-0.20), 22.50 (95% CI: 20.81-24.32) for sensitivity, specificity, PLR, NLR, and DOR, respectively. Moreover, the summary receiver operating characteristics (SROC) curve revealed an AUC value of 0.915 (95% CI: 0.914-0.916), suggesting an outstanding diagnostic accuracy for overall miRNA panels. Subgroup and meta-regression analyses demonstrated that miRNA panels have the highest diagnostic accuracy within serum samples, rather than in other sample-types - with a sensitivity, specificity, PLR, NLR, DOR, and AUC of 0.87, 0.86, 7.33, 0.13, 55.29, and 0.943, respectively. Sensitivity analysis revealed that DOR values did not differ markedly, which indicates that the meta-analysis had strong reliability. Furthermore, this study demonstrated no proof of publication bias for DOR values analyzed using Egger's regression test (P > 0.05) and funnel plot. Interestingly, miR-15b, miR-21 and miR-31 presented the best diagnostic accuracy values for CRC with sensitivity, specificity, PLR, NLR, DOR, and AUC values of 0.95, 0.94, 17.19, 0.05, 324.81, and 0.948, respectively.

Conclusion: This study's findings indicated that miRNA panels, particularly serum-derived miRNA panels, can serve as powerful and promising biomarkers for early CRC screening.

Systematic review registration: [www.crd.york.ac.uk/prospero], identifier [CRD42021268172].

Keywords: biomarker; colorectal cancer; diagnostic; miRNA; panels.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the literature study process and selection.
FIGURE 2
FIGURE 2
QUADAS-2 assessment of studies in terms of risk of bias and applicability concerns’ (A) graph and (B) summary.
FIGURE 3
FIGURE 3
Forest plots for studies on overall microRNAs (miRNAs) used in the diagnosis of CRC among 20 studies included in the present meta-analysis. (A) Sensitivity; (B) specificity.
FIGURE 4
FIGURE 4
Forest plots for studies on overall microRNAs (miRNAs) used in the diagnosis of CRC among 20 studies included in the present meta-analysis. (A) PLR; (B) NLR; (C) DOR.
FIGURE 5
FIGURE 5
Summary receiver operator characteristic (SROC) curves based on microRNA panels of the included studies.
FIGURE 6
FIGURE 6
Funnel plot showing no publication bias in terms of diagnostic odds ratio values among the included.
See this image and copyright information in PMC

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References

    1. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol. (2019) 14:89–103. 10.5114/pg.2018.81072 - DOI - PMC - PubMed
    1. Golshani G, Zhang Y. Advances in immunotherapy for colorectal cancer: a review. Therap Adv Gastroenterol. (2020) 13:1756284820917527. 10.1177/1756284820917527 - DOI - PMC - PubMed
    1. Brouwer NPM, Bos ACRK, Lemmens VEPP, Tanis PJ, Hugen N, Nagtegaal ID, et al. An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients. Int J Cancer. (2018) 143:2758–66. 10.1002/ijc.31785 - DOI - PMC - PubMed
    1. Bakkers C, Simkens GAAM, De Hingh IHJT. Systemic therapy in addition to cytoreduction and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases: recent insights from clinical studies and translational research. J Gastrointest Oncol. (2021) 12:S206–13. 10.21037/jgo-20-133 - DOI - PMC - PubMed
    1. Danese E, Montagnana M, Lippi G. Circulating molecular biomarkers for screening or early diagnosis of colorectal cancer: which is ready for prime time? Ann Transl Med. (2019) 7:610. 10.21037/atm.2019.08.97 - DOI - PMC - PubMed

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