| Objective Analyze the sensitivity and specificity of miRNAs in the diagnosis of lymphoma and determine their potential diagnostic value as novel biomarkers.Methods The Medline, Embase, Pubmed, Web of science,Wanfang and CNKI databases were searched with Lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma,primary central nervous system lymphoma, diffuse large B cell lymphoma,microRNAs, miRNAs, miRs, meta-analysis from the inception of the databases to January.02,2015. We manually searched the reference of relevant reviews to obtain additional articles as well. We try to collect all the article about miRNAs might be used as biomarkers for lymphoma early detection. The qualities of included studies were measured by Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). At last meta-analysis was performed using STATA 12.0 software.Results1. The Meta analyses were based on 14 studies involving 416 lymphoma patients and 293 controls.2. Lymphoma patients were comprised of NHL, NK/T cell lymphoma, PCNSL and DLBCL, while controls were consisted of healthy individuals and patients with neurologic disorders. All of these studies were based on Asian and Caucasian populations. The quality assessments for the studies were evaluated by their QUADAS-2 scores separately. From those scores, we have got a average score 5.3. The results about miRNAs might be used for lymphoma early detection by Meta analysis are as follows:sensitivity,0.91 (95% CI:0.83-0.95); specificity,0.84 (95% CI:0.75-0.90); PLR,5.50 (95% CI:3.50-8.80); NLR,0.11 (95% CI:0.06-0.21); and DOR,50 (95% CI:19-128).4. Integrate the sensitivity and specificity of the research to draw ROC. TheAUC value of the research is 0.93 (95% CI:0.91-0.95). Fagan’s nomogram was used for calculating post-test probabilities with PLR value of 6 and NLR value of 0.11,5. The random-effects bivariate model and bivariate normality analyses confirmed the robustness of goodness of fit. Deeks’funnel plot asymmetry test was used to assess the publication bias of included studies. The result suggesting there were non-significant publication bias in the dataConclusions The miRNAs could be used as potential biomarkers for lymphoma early detection with high accuracy. The miRNAs assays could differentiate lymphoma patients from controls with a relatively high accuracy.Objective To improve the rate and accuracy of diagnosis, the clinical and laboratory characteristics of hemophagocytic lymphohistiocytosis (HLH) were analyzed in and compared between adults and children in a Chinese cohort.Methods The description epidemiology method was used in the research 50 HLH patients including 34 adults and 16 children who fulfilled the "HLH-2004" diagnostic criteria were collected. A retrospective analysis of their data was investigated. Statistical analysis was carried out with SPSS20.0.Results1. There is no significant gender difference in HLH patients. In children group the HLH patients concentrated in infants. But in adults group HLH patients were distributed in various stages.2. The etiology of HLH was very complicated and was still unknown in quite a lot of the patients. However etiological factors were different between the adult group and the pediatric group. Although infection was the most common cause both in the two groups, bacterial infection associated HLH was predominant in adults group. While EB virus infection associated HLH was predominant in children group. The proportions of fungal infection and lymphoma were higher in adults compared with children.3.The time interval from onset of symptoms to clinical diagnosis was significantly shorter in pediatric patients(7 days) than that in adults(lldays) (P<0.05).4. Fever, hepatomegaly, splenomegaly, lymphadenectasis, serous cavity effusions, coagulation disorders, respiratory system symptom, nervous system symptom and jaundice were the typical clinical manifestations in HLH. The proportions of hepatomegaly, splenomegaly and jaundice were much lower in adults than in children. Meanwhile, hydrops of the serous cavity was more common in adult patients than in children.5. The mainly abnormal laboratory examination of HLH were pancytopenia; the rise of ALT, AST, TB, LDH, Y-GGT, TG, SF; the reduce of Fib; hemophagocytosis. Compared with adults, the incidences of HGB<90g/L, TB>19mmol/L and LDH> 500U/L were higher in children.6. Compare the main indicators between male and female in two groups, no differences existed in different gender(P≥0.05). There was no statistical difference between male and female in two groups.7. HLH patients accepted non-chemotherapy or immunochemotherapy. Laboratory parameters were compared between before and after the therapy. The level of SF, AST and LDH changed significantly in non-chemotherapy group (P<0.05). While the level of PLT, AST and LDH changed significantly in immunochemotherapy group (P<0.05).Conclusions1. There were various and multiplex etiologies and clinical manifestations in HLH patients. When patients presented with long-term fever, hepatosplenomegaly, lymphadenectasis, coagulation disorders, pancytopenia, liver dysfunction, the rise of LDH and SF, they should be highly suspected with HLH.2. There were some different clinical features between the two groups. The less characteristic clinical presentation of HLH in adults may make the disease more difficult to diagnose.3. The level of SF and LDH both decreased dramatically no matter the HLH patients accepted immunochemotherapy or non-chemotherapy. So the decrease of SF and LDH can be used to evaluate the treatment outcome of HLH. |
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