Meta-analysis of diagnostic and prognostic value of miR-126 in non-small cell lung cancer.

Lin Sun,Chang Li,Hongbin Zhou,Yong Wang,Min She,Jianguo Chen,Ying Yang

doi:10.1042/bsr20200349

Abstract

In recent years, many studies on the relationship between the expression of microRNA-126 (miR-126) and the diagnostic and prognostic value of non-small cell lung cancer (NSCLC) have been made, but the results were still controversial. The aim is to explore the expression of miR-126 and the diagnosis and prognosis value of NSCLC, and to provide relevant evidence for clinical diagnosis and treatment. Literature related to miR-126 and NSCLC were searched in PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang from the inception to February 2020. Stata 15.0 was used for meta-analysis. The diagnostic value data were used to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and the prognostic value data were used to calculate the pooled risk ratio (hazard ratio, HR) of overall survival (OS) and its 95% confidence interval (95% CI). Thirteen studies were included, among which five were related to diagnosis containing 439 patients and 463 healthy controls, and eight related to prognosis containing 1102 patients. The results of miR-126 expression and diagnostic value of NSCLC showed that the pooled sensitivity was 0.83 (95% CI: 0.59–0.94), specificity = 0.83 (95% CI: 0.71–0.90), PLR = 4.78 (95% CI: 2.97–7.69), NLR = 0.20 (95% CI: 0.08–0.54), DOR = 23.48 (95% CI: 7.87–70.10), and the area under the summ ary receiver operating characteristic curve (SROC) was 0.89 (95% CI: 0.86–0.91). The results of prognostic value indicated that the expression of miR-126 was related to the OS of NSCLC (HR = 0.79, 95% CI: 0.63–0.98). In conclusion, the expression of miR-126 has medium diagnostic value, and it is related to the prognosis of patients with NSCLC, with poor prognosis of miR-126 low expression.

Highlights

Lung cancer is one of the leading causes of cancer deaths in the world, accounting for approximately one-fifth of all cancer deaths [1], including two major groups: non-small cell lung cancer (NSCLC), is approximately 85% of cases and small cell lung cancer (SCLC) is approximately 15%
The results showed that the combined sensitivity was 0.83 and combined specificity was 0.83, positive likelihood ratio (PLR) = 4.78, negative likelihood ratio (NLR) = 0.20, diagnostic odds ratio (DOR) = 23.48, and the area under of summ ary receiver operating characteristic curve (SROC) curve was 0.89
The present study had some limitations: (1) in terms of the diagnostic accuracy, only five studies met the criteria of combined analysis, and the samples were taken from plasma, serum and sputum, which may have a certain effect on the heterogeneity; (2) there was a great heterogeneity in the accuracy of miR-126 in the diagnosis of NSCLC. The source of this heterogeneity may be due to the tumor stage, the source of samples etc, but due to the limited number of studies, it was impossible to perform subgroup analysis to determine the source of heterogeneity; (3) there may be a certain correlation between miR-126 and chemotherapy sensitivity, which may affect the prognosis of patients; (4) the present study only focused on the meta-analysis of diagnostic value and prognostic value of miR-126 in NSCLC, not combined with other possible biomarkers

Summary

Introduction

Lung cancer is one of the leading causes of cancer deaths in the world, accounting for approximately one-fifth of all cancer deaths [1], including two major groups: non-small cell lung cancer (NSCLC), is approximately 85% of cases and small cell lung cancer (SCLC) is approximately 15%. The prognosis of lung cancer depends on whether early clinical diagnosis and treatment are conducted. Radiotherapy is one of the optional treatments for patients with an unresectable area in early stage of lung cancer [3]. Only 16% of patients present with localized diseases at the time of initial diagnosis, and the vast majority of patients are diagnosed with regional (22%) or distant (57%) metastasis and lose the opportunity for surgery. Many patients are at an advanced stage when they are diagnosed and lose the opportunity for early treatment. Since the NSCLC patient accounts for the majority of lung cancer patient, it is of great clinical significance to look for NSCLC markers with high sensitivity and specificity. MicroRNAs (miRNAs) are a class of regulatory noncoding RNAs with a length of 20–25 bases, which can

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