Abstract
Backgrounds and Purpose: Currently, circulating microRNAs (miRNAs) are considered to be non-invasive diagnostic biomarkers in a broad range of tumors. Nevertheless, so far, miRNAs have not been fully applied to the clinic for routine screening in glioma patients. Thus, our goal is to evaluate the diagnostic performance of circulating miRNAs for gliomas via a meta-analysis. The present study is registered on the PROSPERO website, with the number CRD42020195883.Methods: Literature retrieval was implemented in the PubMed, Embase, and Web of Science databases using the established search strategy. We pooled the sensitivity, specificity, and its 95% confidence intervals (CIs) for the included studies using the Stata 14.0 software. In addition, the heterogeneity between studies was assessed via the Q statistics and I2 values calculated by a Chi-square test. A bivariate random effects model was selected due to significant heterogeneity. Specifically, for exploring the factors influencing the heterogeneity, we implemented subgroup and meta-regression analyses. Ultimately, a Deek's funnel plot asymmetry test was used to estimate the potential publication bias.Results: A total of 18 articles covering 24 studies were included, containing 2,170 glioma patients and 1,456 healthy participants. The overall pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were 0.84 (95%CI: 0.79–0.87), 0.84 (95%CI: 0.80–0.88), 5.3 (95%CI: 4.1–6.8), 0.19 (95%CI: 0.15–0.25), 27 (95%CI: 18–41), and 0.91 (95%CI: 0.88–0.93), respectively. Additionally, the findings revealed that serum miRNAs and miRNA panels presented superior diagnostic performance.Conclusion: Thus, circulating miRNAs have the potential to serve as diagnostic biomarkers for gliomas, but need to be verified via a large pool of prospective studies. Additionally, specific miRNAs still need to be elucidated in the diagnosis of a glioma, especially in the early screening stage. The findings may provide diagnostic and therapeutic strategies for the glioma population.
Highlights
Gliomas originate from brain glial cells and are the most frequent type of intracranial primary tumors [1], accounting for 28% of all tumors [2], and 81% of malignant brain tumors [3]
When the key data were lacking, the two authors would contact the first author. The protocol of this present diagnostic meta-analysis have been registered on PROSPERO (CRD42020195883) and can be found at: https:// www.crd.york.ac.uk/prospero/
We depicted the flow diagram of the study screening according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (Figure 1)
Summary
Gliomas originate from brain glial cells and are the most frequent type of intracranial primary tumors [1], accounting for 28% of all tumors [2], and 81% of malignant brain tumors [3]. Based on a published statistical report of CBTRUS in 2019, the researchers found that the average annual age-adjusted incidence rate (AAAIR) of a glioma was approximately 7.87 per 100,000 from 2012 to 2016 in the United States [1]. The astrocytoma and oligodendroglioma are the most commonly seen in the glioma population, on the basis of the World Health Organization (WHO) classification, gliomas are classified into a low-grade glioma (LGG, grades I-II), and a high-grade glioma (HGG, grades III-IV) [4, 5], and the WHO incorporated molecular biomarkers for the sub-classification of gliomas in 2016 [6]. According to previously established knowledge, an LGG had an approximate 43% possibility of 10-year survival [7]. Once the patients suffering from an LGG progress to a HGG, especially glioblastoma (GBM) with grade IV, it has been reported that patients only have a 15-month average survival time [8]. The early identification of gliomas is essential for clinicians
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