| Background and aim:Neuroblastoma(NB)is the most common solid extracranial tumor in infancy,which accounts for 8-10%of malignant tumors in children.Neuroblastoma has the characteristics of occult onset,it is difficult to diagnose in the early stages of the disease,and it is often in the advanced stage when it is discovered.Even if comprehensive treatment such as chemotherapy,surgery,radiation therapy,immunotherapy is performed,a significant proportion of patients still have local recurrence and distant metastasis risk,poor prognosis,and low long-term survival.More and more studies show that miRNAs(microRNAs)play an important role in the occurrence and development of neuroblastoma,mainly acted as tumor suppressors and oncogenes,which affect the survival time of children with NB and have potential prognostic value.The purpose of this study was to investigate the correlation between the expression of miRNAs and the prognosis of neuroblastoma through a meta-analysis.Design:Systematic review and meta-analysisMethod:A comprehensive keyword search was used to search the literature.The literatures published from 2000 to 2020 in Pubmed,Embase,Medline,Web of science and other databases were used to search the literature on the relationship between miRNAs and neuroblastoma prognosis.Data were extracted from each standard-compliant literature for meta-analysis.In this paper,statistical software STATA 12.0 was used to statistically analyze the included research data,assess heterogeneity between studies,and calculate the combined HR(hazard ratio)and 95%CI(confidence interval).If there is heterogeneity,find its source through subgroup analysis and regression analysis.The publication bias is assessed by funnel plots,and further verify with Begg's test,P<0.05 has statistical significance.Results:The meta-analysis includes a total of 14 articles and 35 studies based on the inclusion and exclusion criteria,including 2704 samples and 20 miRNAs.The combined results show that the HR(95%CI)of OS(Overall Survival)is 2.28(95%CI:1.75-2.82),the HR(95%CI)of PFS(Progression Free Survival)is 1.81(95%CI:1.50-2.12),and the HR(95%CI)of EFS(Event Free Survival)is 3.04(95%CI:1.79-4.29),and the HR(95%Cl)of DFS(Disease Free Survival)is 2.03(95%CI:1.54-2.52),which suggested that the abnormal expression of miRNAs was strongly correlated with the prognosis of neuroblastoma.At least two studies have identified five miRNAs(miR-137,miR-487b,miR-181c,miR-192and miR-204)that have important implications for the prognosis of neuroblastoma,emphasizing that low expression of miR-181c,miR-137,miR-487b,and miR-204 and high expression of miR-192 are related to the poor prognosis of neuroblastoma.Conclusion:This meta-analysis shows that miRNAs,especially miR-204,have a suggestive role in the prognosis of children with NB,are a promising biomarker for predicting survival outcomes,and may be potential targets for tumor treatment.These molecules should be combined with other clinical manifestations and molecular biomarkers to assess the best treatment for children with NB. |
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