Upregulated long non-coding RNAs demonstrate promising efficacy for breast cancer detection: a meta-analysis

Focusing on the latest literature, dysregulated long non-coding RNAs (lncRNAs) have been extensively explored in breast cancer (BC) research. The purpose of this meta-analysis is to synthesize the evidence on the diagnostic performance of abnormally expressed lncRNAs for BC.

Relevant studies were searched in multiple electronic databases. The Quality Assessment of Diagnosis Accuracy Studies II criteria were applied to assess the quality of included studies. The bivariate meta-analysis model was applied to synthesize the diagnostic parameters using Stata 12.0 software. Publication bias was judged in terms of the Deek's funnel plot asymmetry test.

We included 10 eligible studies, which comprised 835 BC patients and 725 paired controls for this meta-analysis. The pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio positive, likelihood ratio negative, and area under the curve (AUC) of upregulated lncRNA expression signature in confirming BC were 0.79 (95% CI: 0.70-0.85), 0.80 (95% CI: 0.73-0.85), 14.61 (95% CI: 10.91-19.55), 3.90 (95% CI: 3.03-5.02), 0.27 (95% CI: 0.20-0.36), and 0.86, respectively. Stratified analyses yielded a sensitivity of 0.83 (95% CI: 0.80-0.86) for serum-based analysis, which was higher than plasma-based analysis, whereas plasma-based analysis revealed a greater specificity of 0.88 (95% CI: 0.85-0.91). Moreover, lncRNA-homeotic genes (HOX) transcript antisense RNA showed a pooled specificity of 0.89 (95% CI: 0.84-0.93) and AUC of 0.86, which were superior to performances by lncRNA-metastasis-associated lung adenocarcinoma transcript-1 and -H19 in diagnosing BC. Notably, the analysis based on cancer subtypes demonstrated that lncRNA expression signature could distinguish triple-negative BC (lacks estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression) from non-triple-negative BC, with an AUC of 0.85.

Upregulated lncRNAs reveal an immense potential as novel non-invasive biomarker(s) that could complement BC diagnosis.