Exosomal microRNAs as novel diagnostic biomarkers in breast cancer: A systematic evaluation and meta-analysis.

Circulating tumor-derived exosomal microRNAs (miRNAs) play a key role in the development of cancer. We aimed to assess the diagnostic value of circulating exosomal miRNAs in breast cancer (BC). A computer search was conducted for clinical studies on exosomal miRNA diagnosis of breast cancer published in Wanfang, CNKI, China Biology Medicine disc, VIP, Web of Science, Cochrane Library, PubMed, and Embase built up to August 16, 2022. True/false positive (TP/FP) and true/false negative (TN/FN) rates were extracted from each eligible study to obtain pooled sensitivities, specificities, positive/negative likelihood ratios (PLR/NLR), diagnostic odds ratio (DOR), and their 95% confidence intervals (95% CI). The meta-analysis included 7 articles including 348 Asian patients and 260 controls. All miRNAs were quantified using qRT-PCR assays. The sensitivity and specificity of the combination were 0.67 (95% CI = 0.64-0.71) and 0.81 (95% CI = 0.77-0.86), respectively. The combined DOR was 10.2 (95% CI = 6.00-16.74). The combined AUC(area under the subject operating characteristic curve) was 0.83 (0.91-0.96). In conclusion, exosomal-derived miRNA can be a good indicator to improve the diagnosis of breast cancer.

The predictive value of circular RNAs in the diagnosis, prognosis and clinicopathological features of thyroid cancer: A systematic review and meta-analysis.

OBJECTIVE: An increasing number of studies have reported circular RNAs (circRNAs) as new potential diagnostic and prognostic biomarkers for thyroid cancer. However, the overall predictive value of circRNAs for thyroid cancer remains unclear. Therefore, we performed a comprehensive meta-analysis to investigate the predictive value of circRNAs in the diagnosis, prognosis and clinicopathological features of thyroid cancer (TC). METHODS: PubMed, Embase, Cochrane library and Web of science were searched systematically. The search time limit was from the establishment of the database to October 2021. We used the subject words combined with free words for the search. Furthermore, we used Review Manager 5.3 and Meta-Disc1.4 for relevant data analysis, and Stata 13.1 for sensitivity analysis and publication bias test. The combined sensitivity and specificity were used to evaluate the diagnostic value of circRNAs. The hazard ratio (HR) and its 95% confidence interval (95%CI) were used for statistical analysis of the prognosis of TC. The clinical characteristics were analyzed with Odds Ratio (OR) and its 95% CI. P = 0.05 for all analysis, Q test and I2 analysis were used for heterogeneity evaluation, I2 ≤ 50% and Q test P > 0.1, indicated the lack of heterogeneity. RESULTS: A total of 26 eligible studies including 18 on clinicopathological studies, 7 on prognostic and 6 diagnostic studies were enrolled in our meta-analysis. A total of 1911 patients with TC were included. For the clinicopathological and prognostic value, the results showed that a high expression of circRNAs was correlated with poor clinical parameters, such as the tumor size [OR = 2.79, 95%CI (1.88, 4.13)], extra-glandular metastasis (ETE) [OR = 0.74, 95%CI (0.45, 1.53),P = 0.24], TNM staging [OR = 3.82, 95%CI (2.86, 5.10)], lymph node metastasis (LNM) [OR = 3.88, 95% (2.90, 5.19)], tumor focality [OR = 31.87, 95%CI (1.05, 3.31)] and poor overall survival (OS)[ HR = 1.97, 95%CI (1.37, 2.83)]. For the diagnostic value, the sensitivity, specificity and Area Under Curve (AUC) of the combined group were 0.83 [95%CI (0.77-0.87)], 0.77 [95%CI (0.71-0.82)] and 0.91 respectively. CONCLUSIONS：: CircRNAs have a potential diagnostic value for TC. Meanwhile, an elevated expression of circRNAs has been linked to a poor OS in TC patients, and it also associates with poor prognosis of thyroid cancer patients. The expression of circRNAs is also correlated with certain clinical characteristics, suggesting that it may have important clinical significance.