Abstract
Colorectal cancer (CRC) is a major cause of cancer-related death and cancer-related incidence worldwide. The potential of microRNA-21 (miR-21) as a biomarker for CRC detection has been studied in several studies. However, the results were inconsistent. Therefore, we conducted the present meta-analysis to systematically assess the diagnostic value of miR-21 for CRC. Using a random-effect model, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated to evaluate the diagnostic performance of miR-21 for CRC. A summary receiver operating characteristic (SROC) curve and an area under the curve (AUC) were also generated to assess the diagnosis accuracy of miR-21 for CRC. Q test and I2 statistics were used to assess between- study heterogeneity. Publication bias was evaluated by the Deeks' funnel plot asymmetry test. A total of 986 CRC patients and 702 matched healthy controls from 8 studies were involved in the meta-analysis. The pooled results for SEN, SPE, PLR, NLR, DOR, and AUC were 57% (95%CI: 39%-74%), 87% (95%CI: 78%- 93%), 4.4 (95%CI: 2.4-8.0), 0.49 (95%CI: 0.32-0.74), 9 (95%CI: 4-22), and 0.83 (95%CI: 0.79-0.86), respectively. Subgroup analyses further suggested that blood-based studies showed a better diagnostic accuracy compared with feces-based studies, indicating that blood may be a better matrix for miR-21 assay and CRC detection. Our findings suggest that miR-21 has a potential diagnostic value for CRC with a moderate level of overall diagnostic accuracy. Hence, it could be used as auxiliary means for the initial screening of CRC and avoid unnecessary colonoscopy, which is an invasive and expensive procedure.
Highlights
Colorectal cancer (CRC) is the third most common cancer and ranks second to lung cancer, with more than 1.2 million new cases being diagnosed per year worldwide (Janakiram and Rao, 2008; Jemal et al, 2011)
When the accurate data of sensitivity and specificity were not presented in the articles directly, we estimated the values from the receiver operator characteristic (ROC) curves manually
The 8 studies included in the present meta-analysis contains 968 CRC patients who have been confirmed using histopathology and 702 matched healthy controls
Summary
Colorectal cancer (CRC) is the third most common cancer and ranks second to lung cancer, with more than 1.2 million new cases being diagnosed per year worldwide (Janakiram and Rao, 2008; Jemal et al, 2011). Due to the outstanding decline of the mortality rate of CRC at an early stage, efficient diagnostic methods by which the cancer can be detected earlier are urgently needed. Conclusions: Our findings suggest that miR-21 has a potential diagnostic value for CRC with a moderate level of overall diagnostic accuracy. It could be used as auxiliary means for the initial screening of CRC and avoid unnecessary colonoscopy, which is an invasive and expensive procedure
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