Abstract
Urine UCA1 has been reported as a potential novel diagnostic biomarker for bladder cancer in several studies, but their results are inconsistent. As a result of this, a diagnostic meta-analysis to assess the diagnostic performance of urine UCA1 in detecting bladder cancer was conducted. A systematic electronic and manual search was performed for relevant literatures through PubMed, Cochrane library, Chinese Wan Fang and the China National Knowledge Infrastructure (CNKI) databases up to December 30, 2016. The quality of the studies included in this meta-analysis was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. All analyses were conducted using stata12.0 software. Six studies collectively included 578 bladder cancer patients and 562 controls met the eligible criteria. The overall diagnostic accuracy was measured by the following: sensitivity 0.81 (95% CI = 0.75-0.86), specificity 0.86 (95% CI = 0.73-0.93), positive likelihood ratio 5.85 (95% CI = 2.72-12.57), negative likelihood 0.22 (95% CI = 0.15-0.32), diagnostic odds ratio 27.01 (95% CI = 8.69-83.97), and area under the curve 0.88 (95% CI = 0.85-0.91). Meta-regression analysis suggested that ethnicity significantly accounted for the heterogeneity of sensitivity. Deeks’ funnel plot asymmetry test (P = 0.33) suggested no potential publication bias. According to our results, urine UCA1 has greater diagnostic value in diagnosing bladder cancer, however further research studies with more well-designed and large sample sizes are required to confirm our findings.
Highlights
Bladder cancer (BC) is the second most common urogenital malignancy, with 50% recurrence rate and 15-40% growing into muscle invasive disease [1, 2]
All the included studies used urine sediment as specimens and used reverse transcription polymerase chain reaction (RT-PCR) or quantitative RT-PCR method to determine the expression of urothelial carcinoma associated 1 (UCA1) in urine sediment
Bladder cancer can be initial diagnosed by screening cystoscopy, random bladder biopsies, and voided urinary cytology, the first two methods are invasive and uncomfortable, and the low sensitivity and high variability of cytology creates a challenge that limits its application in the early diagnosis of bladder cancer due to inter-observer reproducibility [2830]
Summary
Bladder cancer (BC) is the second most common urogenital malignancy, with 50% recurrence rate and 15-40% growing into muscle invasive disease [1, 2]. The invasive nature of cystoscopy and low sensitivity of cytology restrict their application in the early www.impactjournals.com/oncotarget diagnosis of BC [7, 8]. Exploring more reliable non-invasive detection of new or recurrent bladder cancer is the need of the hour. Accumulating studies have shown that the dysregulation of lncRNAs was closely related to oncogenesis, metastasis, and prognosis in cancers [1214]. Their expression patterns in various cancer types have been extensively identified, and many of these lncRNAs might be used as independent biomarkers for tumor diagnosis and treatment [15,16,17]. UCA1 was detected as a very sensitive and specific urine marker in BC diagnosis [19, 20]
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