| objective: At present,many studies show that there is a closely relationship between the mi RNA and the occurrence and development of malignant tumors.A lot of articles about circulating mi RNA used for diagnosis of breast cancer have been reported.The results show that the efficiency of circulating mi RNA in diagnosis of breast cancer is significantly higher than that of traditional serological markers,such as CEA and CA15.3.But when we observe carefully,it is not difficult to find that there are obvious differences between studies in case selection,sample type,detection method and result report,which makes it difficult for us to get a unified and standardized result.The purpose of this paper is to summarize and analyze the studies' results which used circulating mi RNA as a diagnosis marker of breast cancer,and systematically analyze the related studies results,so as to explore the ability of circulating mi RNA in the diagnosis of breast cancer.Methods : To retrieved common database,such as CNKI,Wanfang,VIP journals Chinese service platform,sinomed,Web of science,OVID and Pubmed.In strict accordance with the inclusion criteria and exclusion criteria,selected the literatures which meet the requirements,extracted the data,such as the first author,published year,the numbers of sample,sensitivity(SEN),specificity(SPE),TP,FP,TN and FN etc..To collate and sum up the corresponding research data,and use Rew Man5 software and stata12 software to carry out meta analysis.Results: A total of 27 articles(6 Chinese and 21 English articles)were included,including 29 independent studies,2338 cases of breast cancer and 1612 cases of healthy controls.The Rewman5.3 software was used to extract and verify the data,and the quality of the 27 articles was also tested by it.Meta analysis was performed by stata12 software.The sensitivity and specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio were fitted by fitting the bivariate mixed effect model.ROC curve was drawn and the area under the curve was calculated to evaluate the diagnostic ability.The results shows that the sensitivity of circulating mi RNA in diagnosis of breast cancer and its 95% CI is 0.87(0.83-0.90),specificity and its 95% CI is 0.84(0.78-0.88),the positive likelihood ratio and its 95% CI is 5.3(3.8-7.6),negative likelihood ratio and its 95% CI is 0.16(0.11-0.21),diagnostic odds ratio and its 95% CI is 34(18-63),AUC and its 95%CI is 0.92(0.89-0.94).To further explore the impact of race origin differences,the type of samples and the number of mi RNA,we conducted a subgroup analysis based on the above cases.Subgroup analysis shows that the serum specimens for the detection of circulating mi RNA is more effectiveness compared to the plasma and whole blood;circulating mi RNA detection in non-Asian population is more effectiveness than Asian population;the combination of various circulating mi RNA detection and detection of single circulating mi RNA in the diagnosis of breast cancer have the same effection.Teterogeneity exists between each studies,to further explore the sources of heterogeneity,meta regression analysis was conducted,the results suggest that racial differences,the number of circulating mi RNA,different sample size and different types of samples,description of the research object or not are the heterogeneity sources of sensitivity;for specificity,racial differences and control group samples with different size as the main heterogeneity source. |
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