Diagnostic value of circulating microRNAs for osteosarcoma in Asian populations: a meta-analysis

A large number of studies have provided new insights into the diagnostic value of circulating microRNAs (miRNA) for osteosarcoma (OS), one of the most common primary malignancies in adolescents. However, inconsistent conclusions on the diagnostic performance of various kinds of miRNAs have been made. To assess the true diagnostic value of circulating miRNA for the early detection of OS in this meta-analysis, multiple databases, including PubMed, EMBASE, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Technology of Chongqing (VIP), were carefully searched for available studies up to October 30, 2015. The quality of each study was scored using the quality assessment of diagnostic accuracy studies-2 (QUADAS-2). Sensitivity and specificity was pooled using a random-effects model. Positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC) were used to measure the diagnostic values. Subgroup and meta-regression analyses were used to find potential sources of heterogeneity. Publication bias was tested with the Deeks' funnel plot asymmetry test. Eight articles with 741 OS patients and 479 healthy controls were finally included in this meta-analysis. The pooled estimations indicated circulating miRNAs has a high accuracy for diagnosing OS, with sensitivity of 0.94, specificity of 0.80, PLR of 4.75, NLR of 0.07, DOR of 69, and AUC of 0.94. In addition, subgroup and meta-regression analyses revealed that the expression patterns of miRNAs obtained from plasma are more credible diagnostic biomarkers than those from serum. In conclusion, as noninvasive biomarkers, circulating miRNAs have a promising future for the diagnosis of OS in Asian populations.