Abstract
BackgroundMicroRNA-34a (miR-34a) is a master regulator of tumor suppression in breast cancer (BC). This systematic review aims to analyze the diagnostic accuracy of miR-34a in the detection of BC as a biomarker.ResultsA total of 1858 BC cases and 494 controls from thirteen eligible studies reported in 9 publications were included. The overall pooled sensitivity, specificity, negative likelihood ratio (NLR), positive likelihood ratio (PLR), and diagnostic odds ratio (DOR) were 85.50% (95% CI: 83.80-87.00%), 70.00% (95% CI: 65.80–74.10%), 0.29 (95% CI: 0.19–0.43), 2.58 (95% CI: 1.91–3.43), and 9.39 (95% CI: 5.47–16.12), respectively. Similarly, the overall area under the curve (AUC) of the summary receiver operating characteristic (SROC) was 0.80, indicating the high conservation of miR-34a as a biomarker. Furthermore, subgroup analysis suggested that the use of miR-34a as a biomarker is more accurate in tissue-based sample of invasive BC. We also indicated that miR-34a is a capable biomarker in diagnosing BC in people of Caucasian descent.Materials and MethodsA systematic search was conducted for eligible publications that address miR-34a expression level in BC cases and noncancerous controls. Diagnostic capacity of miR-34a for BC was assessed using pooled sensitivity and specificity, DOR, and AUC of SROC. PLR and NLR were verified to estimate the miR-34a diagnostic accuracy in clinical level. The quality of the included studies was assessed by QUADAS-2.ConclusionsThese findings suggest miR-34a is a promising non-invasive biomarker in diagnosing BC. Well-designed cohort studies should be implemented to warrant the diagnostic value of miR-34a in clinical purposes.
Highlights
Breast cancer (BC) is the second leading cause of mortality in females worldwide and the most frequently diagnosed cancer in the USA, estimated 14.6% (1.68 million) of all new cancer cases and 40,290 of all cancer-related deaths in 2015 [1, 2]
The overall pooled sensitivity, specificity, negative likelihood ratio (NLR), positive likelihood ratio (PLR), and diagnostic odds ratio (DOR) were 85.50%, 70.00%, 0.29, 2.58, and 9.39, respectively
Subgroup analysis suggested that the use of miR-34a as a biomarker is more accurate in tissue-based sample of invasive breast cancer (BC)
Summary
Breast cancer (BC) is the second leading cause of mortality in females worldwide and the most frequently diagnosed cancer in the USA, estimated 14.6% (1.68 million) of all new cancer cases and 40,290 of all cancer-related deaths in 2015 [1, 2]. Since the BC is a genetically heterogeneous disease, clinical and diagnostic outcomes are widely disparate and routine clinicpathological factors for diagnosis and/or prognosis of BC are potentially limited [3]. Unavailability of hospital insurance, low sensitivity and specificity, high false positives, complexity, and high costs are main limitations of these diagnostic biomarkers to monitor disease progression or recurrence. Protein-based circulating tumor biomarkers, such as www.impactjournals.com/oncotarget carbohydrate antigen 15–3 and tissue polypeptide specific antigen, are already applied in clinical diagnoses, but have low diagnostic sensitivity and specificity [6, 7]. Novel noninvasive diagnostic biomarkers with high sensitivity and specificity for early-stage BC detection are in great need [8]. This systematic review aims to analyze the diagnostic accuracy of miR-34a in the detection of BC as a biomarker
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