Abstract
BackgroundAlpha-fetoprotein (AFP) has been widely used for many years as a serum marker for hepatocellular carcinoma (HCC). However, AFP has been recognized as having poor sensitivity. More and more studies have concluded that circulating microRNAs (miRNAs) might be a promising biomarker that could complement AFP. However, the diagnostic ability of circulating miRNAs has varied among the studies. Therefore, we performed the present meta-analysis to appraise the diagnostic performance of circulating miRNAs as a biomarker for hepatitis B virus-associated HCC (HBV-HCC) patients with low AFP levels.MethodsWe performed a systematic review and meta-analysis of the published literature to assess the diagnostic accuracy of circulating miRNAs in differentiating HBV-HCC patients with low AFP levels from non-HCC controls.ResultsCirculating miRNAs showed promising potential in the diagnosis of HBV-HCC patients with low AFP levels. In the low-AFP HBV-HCC patients, the area under the curve (AUC) was 0.88 (95% confidence interval [CI]: 0.84–0.90). The pooled sensitivity and specificity were 0.84 (95% CI: 0.78–0.88) and 0.76 (95% CI: 0.69–0.83), respectively.ConclusionsThe detection of circulating miRNAs provides a valuable method for the diagnosis of HBV-HCC in patients with low AFP levels.
Highlights
Alpha-fetoprotein (AFP) has been widely used for many years as a serum marker for hepatocellular carcinoma (HCC)
In such a clinical setting, liquid biopsy has emerged as a promising strategy for the diagnosis of HCC [7], especially for patients with low AFP levels (AFP < 400 ng/ml) or even patients who are AFPnegative (AFP < 20 ng/ml)
We formulated a scientific and complete search strategy to identify studies evaluating the diagnostic efficiency of circulating miRNAs for hepatitis B virus-associated HCC (HBV-HCC) patients with low AFP level
Summary
Alpha-fetoprotein (AFP) has been widely used for many years as a serum marker for hepatocellular carcinoma (HCC). A large-scale, Peng et al BMC Gastroenterology (2020) 20:249 multicenter study in China showed that the sensitivity of AFP was only 68% in identifying HCC [6], which is not very satisfactory In such a clinical setting, liquid biopsy has emerged as a promising strategy for the diagnosis of HCC [7], especially for patients with low AFP levels (AFP < 400 ng/ml) or even patients who are AFPnegative (AFP < 20 ng/ml). Circulating miRNAs can sustain stability and avoid being degraded thanks to their various existing forms in the blood, where ribonuclease is richly contained [11] This indicates that circulating miRNAs are a promising novel HCC diagnostic marker
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