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Published on: July 23, 2012
MicroRNAs as Diagnostic Biomarkers in Primary Central Nervous System Lymphoma: A Systematic Review and Meta-Analysis
Xiaohong Zheng1, Parker Li2, Qianqian Dong1,3
1Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Background:
Diagnosing primary central nervous system lymphoma (PCNSL) remains a challenge. MicroRNAs (miRNAs) are promising noninvasive markers for the identification of PCNSL. The present study aims to assess the diagnostic value of miRNAs for PCNSL patients as biomarkers.
Methods:
We systematically searched PubMed, Embase, and the Cochrane library from inception to January 31, 2021. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), together with the summary receiver operator characteristic (SROC) curve, and the area under the SROC curve (AUC) value were used to estimate the overall diagnostic performance. We used Q statistic and I2 to test heterogeneity and used subgroup analyses to investigate the source of heterogeneity. The statistical analyses were independently performed by two investigators using Stata 14.0 and Revman 5.3.
Results:
In total, 11 studies from 6 records were included in the current meta-analysis with 281 PCNSL patients and 367 controls. Our statistical analysis demonstrated that the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.91 (95% CI 0.84-0.95), 0.88 (95% CI 0.84-0.91), 7.48 (95% CI 5.71-9.78), 0.11 (95% CI 0.06-0.19), 70 (95% CI 35-142), and 0.90 (95% CI 0.87-0.92), respectively. The studies had substantial heterogeneity (I2 = 54%, 95% CI 0-100). Two subgroup analyses were conducted based on the type of specimen and miRNAs profiled.
Conclusions:
This meta-analysis indicated that miRNAs were suitable as noninvasive diagnostic biomarkers for PCNSL with high accuracy. In addition, both cerebrospinal fluid-based and blood-based miRNAs assays for PCNSL detection were considered reliable for clinical application. MicroRNA-21 assays also seemed to be more accurate in the diagnosis of PCNSL. Good quality studies with large samples should be conducted to verify our results.
Insights
MicroRNAs (miRNAs) show high accuracy as noninvasive biomarkers for diagnosing primary central nervous system lymphoma (PCNSL). Both cerebrospinal fluid and blood-based miRNA assays are reliable for clinical use, with microRNA-21 being particularly accurate.
Area of Science:
- Biomarkers and Diagnostics
- Oncology
- Molecular Biology
Background:
- Diagnosing primary central nervous system lymphoma (PCNSL) is challenging.
- MicroRNAs (miRNAs) are emerging as promising noninvasive biomarkers for PCNSL detection.
Purpose of the Study:
- To assess the diagnostic value of miRNAs as biomarkers for PCNSL patients.
- To evaluate the overall diagnostic performance of miRNAs for PCNSL.
Main Methods:
- Systematic literature search of PubMed, Embase, and Cochrane library up to January 31, 2021.
- Meta-analysis of pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR), and area under the summary receiver operator characteristic (SROC) curve (AUC).
- Heterogeneity testing using Q statistic and I²; subgroup analyses based on specimen type and miRNAs profiled.
Main Results:
- Included 11 studies with 281 PCNSL patients and 367 controls.
- Pooled sensitivity: 0.91, specificity: 0.88, AUC: 0.90, indicating high diagnostic accuracy.
- Substantial heterogeneity observed (I² = 54%); subgroup analyses explored sources of variation.
Conclusions:
- miRNAs are suitable noninvasive diagnostic biomarkers for PCNSL with high accuracy.
- Cerebrospinal fluid-based and blood-based miRNA assays are reliable for clinical application.
- MicroRNA-21 assays show potential for enhanced PCNSL diagnostic accuracy; further large-scale studies are recommended.
