Abstract
Background: MicroRNAs have altered expression levels in various diseases and may play an important role in the diagnosis and prognosis of colorectal cancer (CRC). Methods: We systemically reviewed and quantitatively synthesized the scientific evidence pertaining to microRNA-20a (miR-20a) as a CRC biomarker. A keyword and reference search in PubMed yielded 32 studies, in which miR-20a was measured in feces, serum, or tumor tissue. Data were extracted from a total of 5014 cancer cases and 2863 controls. Results: Twenty out of 21 relevant studies found that miR-20a was upregulated in CRC patients compared to controls. Meta-analysis revealed a pooled miR-20a fold change of 2.45 (95% CI: 2.24–2.66) in CRC patients versus controls. To estimate sensitivity and specificity of miR-20a as a diagnostic biomarker of CRC, a pooled area under the receiver operating characteristic curve (AUROC) was calculated (0.70, 95% CI: 0.63–0.78). The prognostic capacity of miR-20a was assessed using hazard ratios (HRs) for the overall survival (OS). The meta-analysis estimated the pooled HR for OS to be 2.02 (95% CI: 0.90–3.14) in CRC patients with high miR-20a expression. Conclusions: miR-20a may be a valid biomarker for CRC detection but may not be a strong predictor of poor prognosis in CRC.
Highlights
Colorectal cancer (CRC) is the third most common cancer worldwide and is responsible for approximately 50,000 deaths per year in the United States alone
Once the cancer metastasizes to the lymph nodes and distant organs, the five-year survival rate drops to 60% and 10%, respectively [1]
We systemically review and quantitatively synthesize the evidence pertaining to miR-20a as a colorectal cancer (CRC)
Summary
Colorectal cancer (CRC) is the third most common cancer worldwide and is responsible for approximately 50,000 deaths per year in the United States alone. If detected in the early stages, adenomas can be surgically removed and prognosis is favorable, with the five-year survival rate reaching 90%. In stage IV resectable colon cancer, neoadjuvant chemotherapy may be beneficial in identifying candidates for surgery and improving three-year disease-free survival [2]. MicroRNAs have altered expression levels in various diseases and may play an important role in the diagnosis and prognosis of colorectal cancer (CRC). Methods: We systemically reviewed and quantitatively synthesized the scientific evidence pertaining to microRNA-20a (miR-20a) as a CRC biomarker. Results: Twenty out of 21 relevant studies found that miR-20a was upregulated in CRC patients compared to controls. Meta-analysis revealed a pooled miR-20a fold change of 2.45
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