| Objective:To comprehensively evaluate the diagnostic value of circulating micro RNA for female reproductive system cancers and provide reference and guideline for clinical practice,researches on circulating micro RNA in diagnosis of female reproductive system cancers were collected by using meta-analysis.Methods:Relevant literatures on the diagnostic value of circulating micro RNA for cervical cancer,ovarian cancer and endometrial cancer were retrieved in English and Chinese databases.According to the pre-determined inclusion and exclusion criteria,literatures were systematically screened.Quality Assessment for Diagnostic Accuracy Studies-2(QUADAS-2)was conducted to evaluate the quality of final full-text literatures.Stata software version 15.1 and Meta-Di Sc software version 1.4 were utilized to evaluate and analyze the data.The statistical evaluation indexes included sensitivity,specificity,positive likelihood ratio(PLR),negative likelihood ratio(NLR),diagnostic ratio(DOR).The overall summary receiver operator characteristic curve(SROC)was drawn and the area under the curve(AUC)was calculated.Subgroup analysis and meta-regression were conducted according to the region,type of sample,single or combined micro RNA diagnosis.Results:1.Totally,28 articles were included in this meta-analysis to evaluate the diagnostic value of circulating micro RNA for cervical cancer.The sensitivity of circulating micro RNA for cervical cancer was 0.81(95% CI 0.77-0.84),specificity was 0.84(95% CI 0.81-0.87),PLR was 5.1(95% CI 4.2-6.2),NLR was 0.23(95% CI 0.19-0.27),and DOR was 23(95% CI 17-30).SROC curve was drawn and the AUC was calculated to be 0.89(95% CI 0.86-0.92).The sensitivity,specificity and AUC of circulating micro RNA for cervical cancer in Asian area were 0.82,0.84 and 0.90,respectively;the sensitivity,specificity and AUC of circulating micro RNA for cervical cancer in nonAsian area were 0.50,0.91 and 0.81,respectively.The sensitivity,specificity and AUC of plasma micro RNA for cervical cancer were 0.80,0.76 and 0.85,respectively;the sensitivity,specificity and AUC of serum micro RNA for cervical cancer were 0.81,0.85 and 0.90,respectively.The sensitivity,specificity and AUC of circulating single micro RNA for cervical cancer were 0.81,0.84 and 0.89,respectively;the sensitivity,specificity and AUC of circulating combined micro RNA for cervical cancer were 0.82,0.87 and 0.91,respectively.The sensitivity,specificity and AUC of mi R-18 a for cervical cancer were 0.81,0.85 and 0.90,respectively.The sensitivity,specificity and AUC of mi R-92 a for cervical cancer were 0.62,0.90 and 0.82,respectively.2.Totally,32 articles were included in this meta-analysis to evaluate the diagnostic value of circulating micro RNA for ovarian cancer.The sensitivity of circulating micro RNA for ovarian cancer was 0.79(95% CI 0.75-0.82),specificity was 0.80(95% CI 0.77-0.83),PLR was 4.0(95% CI 3.4-4.7),NLR was 0.27(95% CI 0.23-0.31),and DOR was 15(95% CI 12-20).SROC curve was drawn and the AUC was calculated to be 0.87(95% CI 0.83-0.89).The sensitivity,specificity and AUC of circulating micro RNA for ovarian cancer in Asian area were 0.78,0.80 and 0.86,respectively;the sensitivity,specificity and AUC of circulating micro RNA for ovarian cancer in nonAsian area were 0.80,0.81 and 0.87,respectively.The sensitivity,specificity and AUC of plasma micro RNA for ovarian cancer were 0.80,0.82 and 0.88,respectively;the sensitivity,specificity and AUC of serum micro RNA for ovarian cancer were 0.78,0.80 and 0.86,respectively.The sensitivity,specificity and AUC of circulating single micro RNA for ovarian cancer were 0.77,0.80 and 0.86,respectively;the sensitivity,specificity and AUC of circulating combined micro RNA for ovarian cancer were 0.85,0.84 and 0.90,respectively.The sensitivity,specificity and AUC of mi R-200 family for ovarian cancer were 0.79,0.82 and 0.86,respectively.The sensitivity,specificity and AUC of mi R-21 for ovarian cancer were 0.84,0.78 and 0.83,respectively.3.Totally,8 articles were included in this meta-analysis to evaluate the diagnostic value of circulating micro RNA for endometrial cancer.The sensitivity of circulating micro RNA for endometrial cancer was 0.81(95% CI 0.73-0.88),specificity was 0.83(95% CI 0.74-0.90),PLR was 4.8(95% CI 3.0-7.9),NLR was 0.22(95% CI 0.14-0.35),and DOR was 22(95% CI 10-49).SROC curve was drawn and the AUC was calculated to be 0.89(95% CI 0.86-0.92).The sensitivity,specificity and AUC of circulating micro RNA for endometrial cancer in Asian area were 0.83,0.84 and 0.90,respectively;the sensitivity,specificity and AUC of circulating micro RNA for endometrial cancer in non-Asian area were 0.78,0.81 and 0.86,respectively.The sensitivity,specificity and AUC of plasma micro RNA for endometrial cancer were 0.75,0.83 and 0.83,respectively;the sensitivity,specificity and AUC of serum and blood micro RNA for endometrial cancer were 0.88,0.83 and 0.92,respectively.Conclusions:1.For the first time,we confirmed that the diagnostic value of circulating micro RNA for cervical cancer,ovarian cancer and endometrial cancer were in the high level by utilizing the meta-analysis,which implied that circulating micro RNA could have the potential to become a diagnostic marker for cervical cancer,ovarian cancer and endometrial cancer.2.The sensitivity and specificity of circulating combined micro RNA for cervical cancer and ovarian cancer were higher than that of single micro RNA.3.The sensitivity and specificity of micro RNA in serum samples for cervical cancer were higher than that in plasma samples;the sensitivity and specificity of micro RNA in plasma samples for ovarian cancer were higher than that in serum samples;the sensitivity of micro RNA in plasma samples for endometrial cancer was lower than that in serum and blood samples.4.The diagnostic value of circulating mi R-18 a for cervical cancer was high.5.The diagnostic value of circulating mi R-200 family and mi R-21 for ovarian cancer were high. |
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