miRNA-21 may serve as a promising noninvasive marker of glioma with a high diagnostic performance: a pooled analysis of 997 patients

Xinli Zhao; Zhihong Xiao; Bin Li; Hongwei Li; Bo Yang; Tian Li; Zubing Mei

doi:10.1177/1758835920987650

miRNA-21 may serve as a promising noninvasive marker of glioma with a high diagnostic performance: a pooled analysis of 997 patients

Ther Adv Med Oncol. 2021 Jan 31:13:1758835920987650. doi: 10.1177/1758835920987650. eCollection 2021.

Authors

Xinli Zhao¹, Zhihong Xiao², Bin Li³, Hongwei Li¹, Bo Yang⁴, Tian Li⁵, Zubing Mei⁶

Affiliations

¹ Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
² Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China.
³ Department of Neurosurgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
⁴ Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan Province, 450052, China.
⁵ School of Basic Medicine, Fourth Military Medical University, No. 169 Changle West Road, Xi'an 710032, China.
⁶ Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Anorectal Disease Institute of Shuguang Hospital, 528 Zhangheng Road, Shanghai 201203, China.

Abstract

Background: Although various serum and tissue biomarkers have been investigated for glioma diagnosis, no gold standard has been identified. miRNA-21 was demonstrated to be a promising biomarker for the diagnosis of various brain tumors, whereas there remains uncertainty concerning whether miRNA-21 could be used as a good clinical diagnostic biomarker for glioma. The current meta-analysis aimed to evaluate the diagnostic accuracy of miRNA-21 as a potent biomarker in adults with suspected glioma.

Methods: The Pubmed and Embase databases were searched systematically from inception to January 2020 to identify relevant research reports. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated. Summary receiver operating characteristic (SROC) curves were used to evaluate the overall diagnostic performance. Meta-regression and subgroup analyses were conducted to determine the source of heterogeneity and test the robustness of the results.

Results: From 5394 citations with 997 subjects that met the inclusion criteria, 11 studies were selected. Summary estimates of the diagnostic performance of miRNA-21 were as follows: sensitivity, 0.83 [95% confidence interval (CI): 0.73-0.89]; specificity, 0.92 (95% CI: 0.85-0.96); PLR, 10.20 (95% CI: 5.10-20.30); NLR, 0.19 (95% CI: 0.12-0.31); and DOR, 54 (95% CI: 19-155). The area under the SROC curve was 0.94 (95% CI: 0.92-0.96). Deeks's funnel plot revealed no evidence of publication bias (p = 0.59). Meta-regression analysis suggested that study publication year could attribute to the heterogeneity. Subgroup analysis found miRNA-21 had a constant high diagnostic accuracy across different ethnicity, glioma grade, sample source, and study region.

Conclusion: This meta-analysis demonstrated that miRNA-21 has high diagnostic performance and could serve as a promising noninvasive diagnostic marker for glioma. Further large prospective studies are needed to validate its diagnostic value and its prognostic significance and therapeutic effects.

Keywords: brain tumors; diagnostic accuracy; glioma; meta-analysis; miRNA-21.