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Updated: Mar 25, 2026
Detection of a Circulating MicroRNA Custom Panel in Patients with Metastatic Colorectal Cancer
Published on: March 14, 2019
Diagnostic Value of Fecal MicroRNAs for Colorectal Cancer: a Meta-Analysis
Background:
Though the fecal occult blood test is used for colorectal cancer (CRC) screening worldwide, it lacks sensitivity and specificity for screening an average-risk population. Many studies have suggested that fecal microRNAs (miRNAs) might serve as novel diagnostic indicators of colorectal cancer. However, inconsistent results have also been reported. This meta-analysis aimed to evaluate the feasibility of fecal miRNAs as biomarkers for colorectal neoplasia screening.
Methods:
We systematically searched PubMed, Embase, and Google Scholar for publications concerning the diagnostic value of miRNAs isolated from stool for CRC screening. The quality of each study was scored using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Data from different studies were pooled to estimate the summary sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) using a bivariate model. Summary receiver operator characteristic curves (SROCs) were plotted, and areas under the SROC curve (AUC) were calculated to evaluate the overall test performance. Heterogeneity was tested with the I2 test, and publication bias was tested with Deeks' funnel plot asymmetry test. Potential sources of heterogeneity were analyzed through subgroup analyses and meta-regression.
Results:
Eighteen studies from 9 articles, including 853 patients and 819 controls, were included in this meta-analysis. The pooled sensitivity, specificity, PLR, DLR, and DOR were 0.63 (95% confidence interval [CI]: 0.56 - 0.70), 0.86 (95% CI: 0.77 - 0.92), 4.47 (95% CI: 2.85 - 7.01), 0.43 (95% CI: 0.38 - 0.49), and 10.38 (95% CI: 6.85 - 15.73), respectively. The area under the SROC was 0.77. Meta-regression suggested that different countries (or regions) and sample sizes may be potential sources of heterogeneity.
Conclusions:
Fecal miRNAs are potentially useful noninvasive biomarkers for the diagnosis of CRC, and combining methylated gene markers or FOBT with miRNA markers may be an alternative approach.
Insights
Fecal microRNAs (miRNAs) show potential as noninvasive biomarkers for colorectal cancer (CRC) screening. Combining miRNAs with other markers may improve diagnostic accuracy for colorectal neoplasia.
Area of Science:
- Biomarkers
- Molecular Diagnostics
- Gastroenterology
Background:
- Fecal occult blood test (FOBT) is a standard colorectal cancer (CRC) screening tool but has limitations in sensitivity and specificity.
- Fecal microRNAs (miRNAs) are emerging as potential novel biomarkers for CRC detection.
- Previous studies on fecal miRNAs for CRC screening have yielded inconsistent results.
Purpose of the Study:
- To evaluate the diagnostic accuracy of fecal miRNAs for colorectal neoplasia screening.
- To perform a meta-analysis of existing studies on fecal miRNAs as CRC biomarkers.
- To assess the feasibility of using fecal miRNAs in CRC screening protocols.
Main Methods:
- Systematic literature search of PubMed, Embase, and Google Scholar for relevant studies.
- Quality assessment of included studies using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
- Meta-analysis using a bivariate model to pool sensitivity, specificity, and other diagnostic accuracy metrics.
- Summary receiver operator characteristic (SROC) curve analysis to evaluate overall test performance.
- Heterogeneity and publication bias assessments, with subgroup analyses and meta-regression to explore heterogeneity sources.
Main Results:
- Eighteen studies involving 853 patients and 819 controls were included.
- Pooled sensitivity was 0.63, specificity was 0.86, and the area under the SROC curve was 0.77.
- Meta-regression indicated that geographical region and sample size might contribute to heterogeneity.
Conclusions:
- Fecal miRNAs demonstrate potential as noninvasive biomarkers for colorectal cancer diagnosis.
- Combining fecal miRNAs with methylated gene markers or FOBT could offer an improved screening strategy.
- Further research may refine the use of fecal miRNAs in clinical CRC screening.
