Diagnostic roles of HOX transcript antisense intergenic RNA in cancer

HOX transcript antisense intergenic RNA (HOTAIR) is considered a diagnostic biomarker for cancer; however, results of previous studies on HOTAIR are inconsistent. In this meta-analysis, we aimed to investigate the role of HOTAIR in cancer diagnosis. Medline, PubMed, Embase, Ovid, Web of Science and Cochrane databases were searched for relevant literature up to May 2019. Over all, we included 20 studies from 17 articles on the role of HOTAIR in cancer diagnosis (individual diagnosis) and 7 studies from 6 articles on the role of HOTAIR along with other biomarkers in cancer diagnosis (combinative diagnosis). The sensitivity and specificity of HOTAIR-mediated individual diagnosis of cancers were 0.80 (95% confidence interval [CI], 0.74-0.85) and 0.74 (95% CI, 0.66-0.81), respectively. The sensitivity and specificity of HOTAIR-mediated combinative diagnosis of cancer were 0.82 (95% CI, 0.77-0.87) and 0.86 (95% CI, 0.80-0.91), respectively. The areas under the receiver operating characteristic curve for individual and combinative diagnoses was 0.84 (95% CI, 0.81-0.87) and 0.91 (95% CI, 0.88-0.93), respectively, indicating that a combinative diagnosis has a relatively better diagnostic accuracy (z = -2.22, P = 0.01) than individual diagnosis. In conclusion, HOTAIR levels might be a promising biomarker in cancer diagnosis. In addition, using HOTAIR in combination with other biomarkers showed a relatively better diagnostic accuracy than HOTAIR alone.