摘要
目的通过Meta分析,系统评价循环MiRNA在早期肝癌中的诊断价值及是否存在发表偏倚。方法对中外文数据库进行检索,将符合纳入标准的关于MiRNA用于早期肝癌诊断的文献进行分析,通过Q检验和I2统计各研究间的异质性,并选择合适的效应模型,计算出合并敏感性、特异度及汇总后的工作特征曲线并计算出曲线下面积。进一步通过亚组分析和Meta回归来分析造成异质性的潜在原因及是否存在发表偏倚。结果共19篇文献的43个MiRNA研究被用来做Meta分析,根据肝癌的分析表明循环MiRNA具有相对好的诊断价值,合并灵敏度和特异性分别0.74和0.79,曲线下面积为0.83。另外在亚组分析中以正常人为对照比以疾病做对照显示较高的诊断优势比。单个MiRNA比复合MiRNA展示相对低的诊断优势比。Meta回归表明异质性来源与对照选择、是否复合MiRNA有关(P<0.05),而与内参的选择、表达的MiRNA是否上下调无关(P>0.05)。合并后存在发表偏倚(P<0.10),但亚组中以正常人为对照在肝癌诊断中不存在发表偏倚(P>0.10)。结论循环MiRNA作为潜在标志物在区别正常人和肝癌方面比区别肝病和肝癌方面具有较高的诊断价值,多个MiRNA,具有更好的早期诊断价值。文献分析存在稳定的发表偏倚,为了更有效的应用MiRNA对肝癌的诊断,还需要多中心的进一步研究。
Objective Through Meta-analysis,the diagnostic value of circulating MiRNA in early hepatocellular carcinoma and whether there was publication bias were systematically evaluated. Methods After the researching of Chinese and foreign literature database,literature about MiRNA being used in early liver cancer diagnosis which meet the inclusion criteria was analyzed.The heterogeneity among studies was statically analyzed by Q test and I2,and the appropriate effect model was selected to calculate the working characteristic curve（ SROC） of the combined sensitivity,specificity and aggregate and the area of the curve（ AUC）.Further subgroup analysis and Meta regression were used to analyze the potential causes of heterogeneity and whether publication bias existed. Results 43 MiRNAs studies in a total of 19 articles were used for Meta-analysis.According to the analysis of liver cancer,the circulating MiRNA has a relatively good diagnostic value. The sensitivity and specificity of the combination are 0. 74 and 0. 79 respectively,and the area under the curve（ AUC） is 0.83.Besides,in subgroup analysis a higher diagnostic superiority ratio（ DOR） was found in normal control found compared with disease control group.Single MiRNA shows a relatively low diagnostic superiority ratio over composite MiRNA.Meta regression showed that the source of heterogeneity was related to the choice of control and the combination of MiRNA（ P〈0.05）,but it was not related to the down regulation of MiRNA in the selection and expression of the internal reference（ P〉 0.05）. There was publication bias after the merger（ P〈0.10）,but there was no publication bias in the subgroup（ P〉0.10）. Conclusion As a potential marker,circulating MiRNA has a higher diagnostic value in distinguishing between normal people and liver cancer than liver disease and liver cancer. Multiple MiRNA has better early diagnostic value. There is a stable publication bias in the literature analysis. In order to make more effective use of MiRNA in
作者
方安宁
严家来
Fang Arming;Yan Jialai(Anhui Medical College,Hefei,Anhui 230601,China)
出处
《湘南学院学报（医学版）》
2018年第2期6-13,共8页
Journal of Xiangnan University（Medical Sciences）
基金
安徽省高校自然基金重点项目(KJ2016A380
KJ2018A0797)
安徽省高职高专医学检验教学团队项目(2015jxtd049)
