Abstract
Background: A novel category of non-coding circular RNAs (circRNAs) has been found to be dysregulated in colorectal cancer (CRC) and significantly contribute to its progression. However, the feasibility of using circRNA as a diagnostic biomarker for CRC remains to be elucidated. Herein, we aimed to comprehensively collect and analyze evidence regarding the potential application of circRNAs as diagnostic indicators for CRC.Methods: A comprehensive retrieval of relevant studies dating from January, 2015 to December 2020, was carried out in PubMed, Cochrane Library, and Web of Science. Data regarding the diagnostic accuracy of circRNA for CRC, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC), were obtained from the included studies. Quality assessment of diagnostic accuracy studies (QUADAS-2) was used to assess the methodological quality of each study. Statistical analysis was performed using STAT and RevMan software.Results: Eighteen studies, involving a total of 2021 individuals, were included in the present meta-analysis. The specimens examined included tissue, serum, and plasma. The pooled sensitivity, specificity, DOR, PLR, NLR, and AUC, with a 95% confidence interval (CI), of circRNAs in the diagnosis of CRC were 0.78 (0.71–0.83), 0.73 (0.68–0.78), 9.68 (6.76–13.85), 2.92 (2.45–3.50), 0.30 (0.23–0.39), and 0.81 (0.78–0.85), respectively. Subgroup analysis showed that the upregulated circRNAs in the tissue or plasma possessed relatively higher diagnostic values for CRC than the downregulated circRNAs. There was no significant difference between the tissue-derived and non-tissue-derived circRNA subgroups.Conclusion: circRNA may be used as a diagnostic biomarker for CRC because of its relatively high diagnostic accuracy in distinguishing CRC patients from normal controls. Further prospective studies are needed to identify more representative circRNAs as diagnostic markers for CRC.
Highlights
Colorectal cancer (CRC) is one of the most common malignancies and a leading cause of cancer mortality worldwide; the survival rate of patients with advanced CRC is quite low, necessitating its early diagnosis as well as the development of improved therapeutic strategies to reduce the death rate [1, 2]
Despite its relatively high sensitivity and specificity, its use for the early diagnosis of CRC is still limited in the clinic
Though several clinical biomarkers, such as CA199 and CEA, have been used for tumor diagnosis, the biomarker-generated clues are not reliable for diagnosing CRC owing to their low sensitivity and specificity [4]
Summary
Colorectal cancer (CRC) is one of the most common malignancies and a leading cause of cancer mortality worldwide; the survival rate of patients with advanced CRC is quite low, necessitating its early diagnosis as well as the development of improved therapeutic strategies to reduce the death rate [1, 2]. Despite its relatively high sensitivity and specificity, its use for the early diagnosis of CRC is still limited in the clinic. Though several clinical biomarkers, such as CA199 and CEA, have been used for tumor diagnosis, the biomarker-generated clues are not reliable for diagnosing CRC owing to their low sensitivity and specificity [4]. There is a desperate need for identifying novel feasible biomarkers for CRC diagnosis. A novel category of non-coding circular RNAs (circRNAs) has been found to be dysregulated in colorectal cancer (CRC) and significantly contribute to its progression. The feasibility of using circRNA as a diagnostic biomarker for CRC remains to be elucidated.
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