Circular RNAs as a Diagnostic Biomarker in Oral Squamous Cell Carcinoma: A Meta-Analysis

Abstract

Studies have found a positive correlation between various cancers and circular RNAs (circRNAs), which are newly discovered noncoding RNAs. However, limited scientific evidence is available to prove the clinical value of circRNAs in the presentation of oral squamous cell carcinoma (OSCC). This study aimed to explore comprehensively the potential of circRNAs as diagnostic indexes of OSCC. Online databases were systematically searched to identify published literature on the discovery of circRNAs in OSCC. Data were acquired from each reviewed study and collated to create a 2×2 eventuality table. Hierarchical analysis of the literature was conducted for the type of cancer, year of publication, and the sample size of each study. The diagnostic accuracy was calculated using indexes such as the pooled sensitivity and specificity, and assessed critically using the Quality Assessment for Studies of Diagnostic Accuracy2. This meta-analysis included findings of 6 studies on 335 patients diagnosed with OSCC. These 6 studies examined 7 circRNAs, 5 in tissues and 2 in the saliva of patients with OSCC. When used as a diagnostic tool for OSCC, circRNAs manifested a sensitivity level of 0.72 (95% confidence interval: 0.67 to 0.76) and a degree of specificity of 0.81 (95% confidence interval: 0.76 to 0.85), with a general projected probability rate of 3.82 (95% confidence interval: 2.98 to 4.91) being positive and 0.35 (95% confidence interval: 0.29 to 0.41) being negative. The combined probability rate was 11.07 (95% confidence interval: 7.64 to 16.04), comprising a total of 0.76 (95% confidence interval: 0.72 to 0.79) of the region under the curve. A higher diagnostic value was found for salivary circRNAs (diagnostic odds ratio=17.52; 95% CI: 10.11 to 30.35) than for tissue circRNAs (diagnostic odds ratio=8.47; 95% CI: 5.6 to 12.83). This indicated that circRNAs showed a good discrimination ability as biomarkers of OSCC. circRNAs showed high accuracy in the diagnosis of OSCC and could be used as prospective biomarkers to facilitate the diagnostic process.