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目的:通过Meta分析系统评价血液中miR-21对胰腺癌的诊断价值。方法:检索多个国内外数据库,收集2017年5月以前公开发表的关于miR-21用于胰腺癌诊断的研究数据,按照纳入标准筛选文献、提取资料和质量评价,然后采用Metadisc 1.4和Stata 14.0软件对纳入研究进行Meta分析。结果:共纳入8篇文献,累计261例胰腺癌患者和242例对照。Meta分析结果显示,循环miR-21诊断胰腺癌的合并敏感度为0.76(95%CI=0.71~0.81),合并特异度为0.76(95%CI=0.70~0.81),合并阳性似然比为3.17(95%CI=2.24~4.47),合并阴性似然比为0.26(95%CI=0.15~0.45),合并诊断比值比为13.17(95%CI=6.78~25.58)。综合受试者工作特征曲线下面积(AUC)为0.8518。亚组分析显示,血清和血浆亚组的AUC均为0.8513;健康人群对照亚组的诊断准确性优于健康人群+胰腺良性疾患对照亚组(AUC:0.876 vs.0.72,P<0.05)。诊断性试验Deek漏斗图显示不存在发表偏倚,敏感性分析显示Meta分析结果并未过分依赖于某个研究,结论稳定。结论:循环miR-21用于胰腺癌诊断具有一定的价值。
OBJECTIVE: To evaluate the diagnostic value of miR-21 in the blood on the diagnosis of pancreatic cancer by Meta analysis system. Methods: We searched a number of domestic and foreign databases and collected the published research data on the diagnosis of pancreatic cancer using miR-21 before May 2017. We screened the literature according to the inclusion criteria, extracted data and quality evaluation, and then used Metadisc 1.4 and Stata 14.0 Software Meta-analysis of included studies. Results: A total of 8 articles were enrolled. A total of 261 patients with pancreatic cancer and 242 controls were included. Meta-analysis showed that the combined sensitivity of circulating miR-21 in the diagnosis of pancreatic cancer was 0.76 (95% CI = 0.71-0.81), and the combined specificity was 0.76 (95% CI = 0.70-0.81) with a positive likelihood ratio of 3.17 (95% CI = 2.24-4.47), and the combined negative likelihood ratio was 0.26 (95% CI = 0.15-0.45). The pooled diagnostic odds ratio was 13.17 (95% CI = 6.78-25.58). The area under the receiver operating characteristic curve (AUC) for the composite subjects was 0.8518. The subgroup analysis showed that the AUC of serum and plasma subgroups was 0.8513. The diagnostic accuracy of the healthy subgroup was better than that of the healthy group + benign pancreatic disease control group (AUC: 0.876 vs.0.72, P <0.05). Diagnostic tests Deek funnel plots showed no publication bias, and sensitivity analyzes showed that the Meta analysis did not rely too much on one study and the conclusions were stable. Conclusion: Circulating miR-21 is of value in the diagnosis of pancreatic cancer.