Abstract
Purpose Early detection of esophageal cancer is beneficial to the survival and prognosis of patients. Circular RNAs (circRNAs) have been shown to be a potential biomarker for cancer, which can be used for the diagnosis of esophageal cancer. However, the roles of circRNAs in the diagnosis of esophageal cancer has been controversial. The present study, therefore, is aimed at determining the diagnostic accuracy of circRNAs in esophageal cancer. Methods Relevant researches were searched from PubMed, Embase, Cochrane Library, OVID, and ISI Web of Science online databases up to March 11, 2019. The estimation of diagnostic indicators, threshold effect, and publication bias were measured by a bivariate binomial mixed model, the Spearman correlation, and Deeks' funnel plot asymmetry test, respectively. Results Five studies from 4 articles were included in this meta-analysis. The pooled sensitivity, specificity, overall positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the receiver operating characteristics curve (AUC) were 0.79 (95% CI: 0.69-0.87), 0.85 (95% CI: 0.68-0.94), 5.27 (95% CI: 2.46-11.32), 0.24 (95% CI: 0.16-0.36), 21.66 (95% CI: 9.33-50.30), and 0.88 (95% CI: 0.84-0.90), respectively. The Spearman correlation coefficient was 0.60 (P = 0.285). The P value of Deeks' funnel plot was 0.81. Conclusion The above-mentioned results suggested that circRNAs possess a relatively higher diagnostic performance in distinguishing esophageal cancer patients from healthy individuals. Therefore, they may serve as potential clinical biomarkers for esophageal cancer diagnosis.
Highlights
Esophageal cancer ranks seventh in terms of incidence and sixth in mortality overall, with the highest incidence rate in Eastern Asia [1]
Our meta-analysis has shown that, as a diagnostic biomarker, plasma circRNAs had a relatively high diagnostic accuracy and achieved a combined area under the (sROC) curve (AUC) of 0.88 (Figure 2(b)) with 79% pooled sensitivity (Supplementary Figure 1a) and 85% specificity (Supplementary Figure 1b) in discriminating Esophageal squamous cell carcinoma (ESCC) patients (Table 2)
We found that the overall positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 5.27 and 0.24, respectively
Summary
Esophageal cancer ranks seventh in terms of incidence and sixth in mortality overall, with the highest incidence rate in Eastern Asia [1]. Esophageal squamous cell carcinoma (ESCC) and adenocarcinoma (EADC) are the most common histologic subtypes that have different etiologies [2]. EADC was considered the most common type of esophageal cancer in high-income countries, and its main risk factors were excess body weight and gastroesophageal reflux disease (GERD) ([3]). In China, ESCC was the major type of esophageal cancer, which was caused by multiple etiologies including diet behaviors, lifestyles, and genetic factors [4]. Most esophageal cancer patients have a poor prognosis, due to the late stage at diagnosis. Endoscopy and pathological biopsy are the gold standards for the diagnosis of esophageal cancer [5]. Many researchers were exploring a more accurate and less invasive screening tool to allow the early detection of esophageal cancer
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