Abstract
Background: Lung cancer (LC) is the leading cause of cancer-related death in Eastern Asia. The prognosis of LC highly depends on tumor stages and early detection could substantially reduce LC mortality. Accumulating evidence suggested that circulating miRNAs in plasma or serum may have applications in early LC detection. We thus conducted a systematic literature review on the diagnostic value of miRNAs markers for LC in East Asian populations. Methods: PubMed and ISI Web of Knowledge were searched to retrieve relevant articles published up to 17 September 2018. Information on study design, population characteristics, investigated miRNAs and diagnostic accuracy (including sensitivity, specificity and area under the curve (AUC)) were independently extracted by two reviewers. Results: Overall, 46 studies that evaluated a total of 88 miRNA markers for LC diagnosis in East Asian populations were identified. Sixteen of the 46 studies have incorporated individual miRNA markers as panels (with 2–20 markers). Three promising miRNA panels with ≥90% sensitivity and ≥90% specificity were discovered, two of which were externally validated. Diagnostic performance of circulating miRNAs in East Asian populations was comparable to previously summarized performance in Western populations. Forty-four miRNAs were reported in both populations. No major differences in diagnostic performance by ethnicity of the same miRNA was observed. Conclusions: Circulating miRNAs or miRNA panels, possibly in combination with other promising molecular markers including epigenetic and genetic markers, may be promising candidates for noninvasive LC early detection. However, large studies with samples collected prospectively in true screening settings are required to validate the promising markers or marker panels.
Highlights
Lung cancer (LC) is the leading cause of cancer mortality in Eastern Asia, with 950,015 cases and815,635 deaths estimated in 2018 [1]
All studies listed in the table were from China, except Tai [29] which was from Japan; no mean age or median age but age distribution reported; miRNAs detected with fluorescence quantum dots liquid bead array; d USA validation set not included; SENs, SPEs and AUCs in bold fonts represent results from validation set
Summary
Lung cancer (LC) is the leading cause of cancer mortality in Eastern Asia, with 950,015 cases and. Advances in therapy have led to improvements in survival of LC patients [2], the 5-year survival rate remains very low, mainly due to late diagnosis of disease [3]. Traditional screening methods such as chest radiography and sputum cytology have limited clinical applications as they display low sensitivity and specificity in detection of LC [4]. Because of the genetic diversity of miRNA expression profiles of populations [11], we previously summarized the diagnostic performance of circulating miRNAs restricted to Western populations [12]. We systematically reviewed their diagnostic performance in East Asian populations, paying particular attention to the potential differences between the East Asian and Western populations
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