联合检测CA724、CA199、CEA对胃癌诊断价值的Meta分析

摘 要：［目的］ 系统评价联合检测血清肿瘤标志物（CA724、CA199、CEA）对胃癌的诊断价值。［方法］ 计算机检索PubMed、中国知网、万方、维普等数据库,收集关于CA724、CA199、CEA在胃癌诊断中应用的相关文献。采用Meta-Disc l.4、RevMan 5.2和Stata 13.0进行Meta分析。［结果］ 纳入10篇文献,共1642例。对胃癌诊断中,单独检测CA724的敏感度为0.49(95%CI：0.45~0.53),特异度为0.91(95%CI：0.89~0.93),诊断比值比为10.97(95%CI：8.22~14.63);联合检测的敏感度为0.76(95%CI：0.73~0.79),特异度为0.82(95%CI：0.79~0.84),诊断比值比为19.85(95%CI：10.78~36.52)。单独检测CA724的曲线下面积（AUC）=0.80,Q*=0.74;联合检测的AUC=0.95,Q*=0.90。联合检测和单独检测CA724两种方式的诊断效能差异具有统计学意义（Z=4.86,P＜0.05）。［结论］ CA724联合检测的诊断效能比单独检测CA724要高,对胃癌的辅助诊断具有较高的指导意义。     

18FDG-PET与99TCm-MDP骨扫描对肺癌骨转移诊断价值的Meta分析

摘 要：［目的］ 系统评价18氟脱氧葡萄糖正电子发射断层扫描（18FDG-PET）和亚甲基二膦酸盐（99TCm-MDP）骨扫描对肺癌骨转移的诊断价值。［方法］ 计算机检索国内外重要数据库,依据预先制定的纳入和排除标准筛选文献,对纳入研究采用诊断性试验准确性质量评价工具（QUADAS）进行质量评价,运用Meta-DiSc 1.4、STATA 12.0和RevMan 5.3进行统计分析,检验各纳入研究的异质性,计算合并诊断优势比（DOR）及其95%可信区间（95%CI）、汇总受试者工作曲线（SROC）和曲线下面积（AUC）等指标。［结果］ 共纳入11篇文献。对肺癌骨转移的诊断价值为：（1）基于患者18FDG-PET的DOR及其95%CI为250.16（95%CI：113.42～551.75）,SROC曲线下面积（AUC）=0.9710,Q*=0.9215。99TCm-MDP骨扫描的DOR及其95%CI为22.831（95% CI：9.399～55.461）,SROC曲线下面积（AUC）=0.8952,Q*=0.8261。（2）基于病灶18FDG-PET的DOR及其95%CI为70.149（95%CI：20.297～242.44）,SROC曲线下面积（AUC）=0.9524,Q*=0.8937。99TCm-MDP骨扫描的DOR及其95%CI为4.967（95%CI：1.219～18.096）,SROC曲线下面积（AUC）=0.8851,Q*=0.8156。［结论］ 18FDG-PET对肺癌骨转移的诊断效能优于99TCm-MDP骨扫描,但仍需大样本的研究进一步证实。     

miR-29 家族对恶性肿瘤诊断价值的Meta分析

[摘要] 目的：准确评价微小RNA-29（miRNA-29）对恶性肿瘤的诊断价值。方法：检索3 个英文数据库PubMed、Embase 和Web of Science 以及2 个中文数据库中国知网（CNKI）和万方数据（Wanfang Data）,检索自各数据库建立时间起至2018 年9 月15日miRNA-29 的文献资料,检索词包括miRNA-29（miR-29）、肿瘤、癌、血清、血浆、诊断、tumor、cancer、carcinoma、serum、plasma、diagnosis 等,用诊断准确性研究的质量评价-2（QUADAS-2）工具对纳入文献进行质量控制,用Stata12.0 统计学软件计算合并灵敏度、特异度、阳性似然比、阴性似然比及诊断比值比,采用Meta 回归分析及亚组分析探究异质性来源。结果：从1 172 篇与肿瘤、miR-29 相关的文献中筛选出20 篇文献,其合并灵敏度为0.76（95%CI：0.68~0.83）,合并特异度为0.83（95%CI：0.74~0.89）,合并阳性似然比（PLR）为4.5（95%CI：2.70~7.40）,合并阴性似然比（NLR）为0.28（95%CI：0.20~0.41）,诊断优势比（DOR）为16（95%CI：7~35）,受试者工作特征曲线下面积（AUC）为0.86（95%CI：0.83~0.89）。血浆标本的合并特异度显著高于血清标本（P<0.01）。miR-29 对乳腺癌、胰腺癌诊断价值较高（DOR=101.52、11.22）,对结直肠癌、非小细胞性肺癌诊断价值较低（DOR=5.05、6.57）;miR-29b 对恶性肿瘤诊断价值较高（DOR=60.91）。未发现显著性发表偏倚（P>0.05）。结论：miR-29 对恶性肿瘤有良好的灵敏度与特异度,具有潜在的诊断价值。     

circRNA在中国人群消化道肿瘤中诊断价值的Meta分析

目的:系统评价环状RNA(circular RNA,circRNA)在中国人群消化道肿瘤中的诊断价值。方法:在 PubMed、Cochrane Library、Medline、Embase、万方、知网、维普等数据库检索,筛选2017年6月17日之前发表的可纳入的文献。利用诊断准确度的质量评价工具(QUADAS-2)对文献质量进行评价。采用STATA 14.0软件对灵敏度和特异度进行合并,以及绘制、分析综合受试者工作曲线(SROC)及曲线下面积(AUC)。结果:按照纳入、排除标准,共纳入10篇文献。合并后的灵敏度和特异度为0.68(95%CI:0.57~0.78),0.76(95%CI:0.68~0.83),曲线下面积为0.79(95%CI:0.75~0.82)。亚组分析示肿瘤类型和样本量是异质性的主要来源。Deeks' 漏斗图示本研究存在发表偏倚(P=0.01)。结论:circRNA具有成为诊断消化道肿瘤的新型生物标志物的潜能。     

circRNAs作为胃癌诊断标记物可行性的meta分析

目的：评价环状RNAs作为胃癌诊断标记物的价值。方法：检索PubMed、web of science外文数据库和中国知网、万方中文数据库2015年1月至2018年11月之前发表的相关文献，应用诊断试验质量评价系统（QUADAS-2）对每项研究方法合理性进行评价，采用stata15.0软件分析环状RNAs与胃癌诊断相关性以评估诊断价值，采用stata15.0软件分析参考文献是否存在发表偏倚。结果：13篇参考文献纳入研究，包含1394名患者。环状RNAs作为胃癌诊断标记物的合并敏感度是0.70（95%CI 0.66～0.75），合并特异度是0.72（95%CI 0.68～0.75），合并阳性似然比2.5（95%CI 2.2～2.8），合并阴性似然比0.41（95%CI 0.36～0.48），合并诊断优势比是6（95%CI 5～8），曲线下面积（AUC）0.77（95%CI 0.73～0.80），其中环状RNA Hsa_circ_00001649(AUC:0,83)和hsa_circ_0000096(AUC:0.82)表现出了较高的诊断效率。结论：环状RNAs具有可作为胃癌诊断标记物潜力。     

动态增强磁共振对前列腺癌术后复发或残留诊断的Meta分析

  目的  评价动态增强磁共振（dynamic contrast-enhanced MRI,DCE -MRI）对前列腺癌（PCa）手术治疗后局部复发或残留的诊断效能。   方法  检索PubMed、EMBASE、Cochrane Library、SCI、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、中文科技期刊数据库（VIP）、万方数字化期刊群等数据库,再根据已发表文献中的参考文献追溯进行手工检索。检索时间截止到2013年6月6日。依据纳入排除标准筛选文献,参照QUADAS评价纳入研究的质量并提取数据,利用Meta-Disc 1.4软件进行统计分析,计算总敏感度、特异度、诊断比值比（dOR）及其95%可信区间（95% CI）和SROC曲线下面积（AUC）。   结果  检索得到118篇文献,有7篇文献（12项研究）符合纳入标准。对12项研究进行Meta分析,总敏感性为0.88（95%CI:0.84~0.91）,总特异性为0.87（95%CI:0.81~0.92）,dOR为50.4（95%CI:26.0~97.6）。DCE-MRI对PCa术后复发或残留诊断的SROC AUC为0.9391,Q*指数为0.8764。   结论  动态增强磁共振对诊断前列腺癌治疗后局限性复发或残留具有较高的敏感性与特异性,其中DCE与磁共振波谱（magnetic resonance spectroscopy,MRS）联合诊断效能更高。      

中国人群中miiRNA-21对肺癌诊断价值的Meta分析

目的 通过Meta系统分析评价中国人群中微小RNA-21(miRNA-21)对肺癌的诊断价值.方法 全面检索万方、CNKI、维普、PubMed、Embase数据库,日期从建库至2020年10月,筛选相关文献提取数据,采用QUA-DAS-2标准评估文献质量,再对提取数据行初步合并,以判定异质性和诊断效能,并通过回归分析、敏感性分析及亚组分析探讨异质性来源,最后以漏斗图评估是否存在发表偏倚.结果 共纳入11篇文献,其中病例组1113例,对照组1182例.合并灵敏度和特异度分别为0.76(95％CI:0.73～0.78)和0.75(95％CI:0.72～0.77),阳性似然比和阴性似然比分别为2.85(95％CI:2.54～3.20)和0.33(95％CI:0.28～0.37),诊断比值比(DOR)为9.16(95％CI:7.11～11.80),综合受试者工作特征(SROC)曲线的曲线下面积(AUC)为0.82.样本类型、内参类型及探针类型均可能是异质性来源.亚组分析显示,筛查组织样本、血清样本和SYBR探针时,miRNA-21对肺癌具有很高的诊断价值(DOR=10.61、9.46、9.71),而内参为U6的诊断价值较低(DOR=6.74).结论 中国人群中miRNA-21对肺癌的诊断价值较高,有较高的灵敏度和特异度,可作为一项提高肺癌诊断水平的良好指标.     

核磁共振诊断直肠癌盆腔侧方淋巴结转移价值的Meta分析

目的 系统评价磁共振成像（MRI）对直肠癌盆腔侧方淋巴结转移的诊断价值。方法 计算机检索EMbase、PubMed、The Cochrane Library、CNKI和WanFang Data数据库,搜集磁共振诊断直肠癌盆腔侧方淋巴结转移的相关文献,检索时限均从建库至2019年3月。由两位研究者独立筛选文献、提取资料和评价偏倚风险后,采用Stata 15软件进行统计分析,计算其合并敏感度（Sen合并）、特异性（Spe合并）、诊断比值比（DOR）等,绘制汇总受试者工作特征（SROC）曲线并计算曲线下面积（AUC）。结果 共纳入11个研究,包含1 059例患者。Meta分析结果显示,磁共振诊断侧方淋巴结转移的合并Sen、Spe、+LR、–LR、DOR分别为0.77（95%CI: 0.38~0.88）、0.77（95%CI: 0.69~0.83）、3.3（95%CI: 2.4~4.5）、0.3（95%CI: 0.23~0.41）、11（95%CI: 6~18）,SROC曲线下面积为0.83（95%CI:0.80~0.86）。结论 以淋巴结短径为诊断标准,MRI诊断直肠癌侧方淋巴结转移的敏感度和特异性一般;但在没有更佳的影像学筛查条件下,MRI仍然是被推荐的检查手段。     

非酒精性脂肪性肝病与缺血性脑卒中发病风险的meta分析

目的 系统回顾并量化非酒精性脂肪性肝病（NAFLD）与缺血性脑卒中发病之间的关系。方法 截至 2020年 1月 31日，系统检索了PubMed、Web of Science、中国学术期刊网络出版总库、万方数据期刊论文资源、Cochrane Library、中国生物医 学文献数据库和Embase，使用STATA 15.0进行统计分析，合并纳入研究的OR及95%CI，同时根据地区、诊断方法、血清转氨酶 水平进行亚组分析。结果 共纳入符合标准的9篇文章4206例患者。在8项研究中，NAFLD与缺血性脑卒中之间存在显著关 联（OR=2.53，95%CI=1.83~3.49）。在所有比较中，各研究之间没有发现显著的异质性。在敏感性分析中排除任何一项研究后， 这些结果基本保持不变。按地区进行亚组分析结果显示，在欧美地区，NAFLD患者发生缺血性脑卒中的综合风险为OR=2.17 （95%CI=1.03~4.58）；在亚洲地区，风险为 OR=3.23(95%CI=1.83~5.7)；在非洲，风险为 OR=2.28（95%CI=1.44~3.61）。按脂肪肝 诊断的不同方法进行亚组分析表明，诊断方法可能是影响NAFLD与缺血性脑卒中风险关系的混杂因素（腹部超声诊断，OR= 2.60，95%CI=1.87~3.61；肝脏活检诊断，OR=1.08，95%CI=0.18~6.52）。按血清转氨酶水平进行亚组分析，结果表明谷丙转氨酶 （ALT）水平与 NAFLD 患者发生缺血性脑卒中的风险增加有显著相关性（ALT 的平均差值为 1.14 U/L, 95%CI=0.68~1.61）。谷 草转氨酶（AST）水平与 NAFLD 患者发生缺血性脑卒中风险的增加有显著的相关性（AST 平均水平差异为 0.57 U/L，95%CI= 0.25~0.80）；谷氨酰转移酶（GGT）水平与 NAFLD 患者发生缺血性脑卒中风险的增加有显著相关性（GGT 平均水平差异为 1.08 U/L，95%CI=0.38~1.78）。结论 NAFLD可能会增加缺血性脑卒中的发生风险。     

ERCC1在结直肠癌组织中的表达及预后价值

目的:探究核苷酸切除修复交叉互补基因1（excision repair cross-complementation gene 1，ERCC1）表达对结直肠癌（colorectal cancer，CRC）患者铂类辅助化疗的预后价值。方法:选取2011年01月至2013年01月安徽医科大学附属六安医院行CRC根治术后接受mFOLFOX6方案化疗的患者共84例，通过免疫组化方法评估ERCC1在CRC组织中表达情况，分析ERCC1表达与预后的关联。结果:ERCC1高表达30例（35.7%）。Kaplan-Meier曲线显示ERCC1高表达的CRC患者无病生存期（DFS）和总生存期（OS）均缩短（P均<0.001）。多因素COX分析显示ERCC1高表达（DFS HR=4.645，95%CI:2.045~10.548，P<0.001；OS HR=4.898，95%CI:1.971~12.170，P<0.001）是CRC患者预后的不良因素，分析各亚组患者中ERCC1表达与生存相关性得到相似的结果。复发患者中ERCC1高表达的肝肺转移占68.8%（11/16），低表达的腹腔转移为70.0%（7/10），ERCC1表达与首次复发模式显著相关（P=0.006）。结论:ERCC1表达可作为评价CRC患者预后的重要指标。ERCC1表达可能有助于预测CRC患者辅助化疗后首次复发模式。ERCC1表达的预后价值需进一步研究。     

Detection of MicroRNA-21 Expression as a Potential Screening Biomarker for Colorectal Cancer: a Meta-analysis

Background: Colorectal cancer (CRC) is a major cause of cancer-related death and cancer-related incidenceworldwide. The potential of microRNA-21 (miR-21) as a biomarker for CRC detection has been studied inseveral studies. However, the results were inconsistent. Therefore, we conducted the present meta-analysis tosystematically assess the diagnostic value of miR-21 for CRC. Materials and Methods: Using a random-effectmodel, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio(NLR), and diagnostic odds ratio (DOR) were calculated to evaluate the diagnostic performance of miR-21 forCRC. A summary receiver operating characteristic (SROC) curve and an area under the curve (AUC) were alsogenerated to assess the diagnosis accuracy of miR-21 for CRC. Q test and I2 statistics were used to assess betweenstudyheterogeneity. Publication bias was evaluated by the Deeks’ funnel plot asymmetry test. Results: A totalof 986 CRC patients and 702 matched healthy controls from 8 studies were involved in the meta-analysis. Thepooled results for SEN, SPE, PLR, NLR, DOR, and AUC were 57% (95%CI: 39%-74%), 87% (95%CI: 78%-93%), 4.4 (95%CI: 2.4-8.0), 0.49 (95%CI: 0.32-0.74), 9 (95%CI: 4-22), and 0.83 (95%CI: 0.79-0.86), respectively.Subgroup analyses further suggested that blood-based studies showed a better diagnostic accuracy comparedwith feces-based studies, indicating that blood may be a better matrix for miR-21 assay and CRC detection.Conclusions: Our findings suggest that miR-21 has a potential diagnostic value for CRC with a moderate levelof overall diagnostic accuracy. Hence, it could be used as auxiliary means for the initial screening of CRC andavoid unnecessary colonoscopy, which is an invasive and expensive procedure.     

Gail模型在我国女性乳腺癌发病风险预测中的研究:系统综述与Meta分析

目的:评价Gail模型对我国女性乳腺癌发病风险预测的区分度和诊断准确性.方法:在PubMed、SpringerLink、中国知网、万方医学数据库中系统检索Gail模型对我国女性乳腺癌发病风险预测研究.由两位研究者对符合纳入标准的文献独立进行数据提取和质量评价.采用DerSimonian和Laird's随机效应模型评估G...     

Diagnostic value of alpha-l-fucosidase for hepatocellular carcinoma: a meta-analysis

Alpha-fetoprotein (AFP) is the primary marker for detecting hepatocellular carcinoma (HCC) and has been used widely in the clinic, but AFP is a biomarker characterized by poor sensitivity and specificity. Alpha-l-fucosidase (AFU) has been proposed as a tumor marker for diagnosis of HCC in many studies. However, conclusions of its diagnostic value are inconsistent. The current review aimed to evaluate the diagnostic value of AFU for HCC. After systematic review of 12 related studies, sensitivity, specificity, and diagnostic odds ratio (DOR) were pooled using random-effect models. Summary receiver operating characteristic (sROC) curve analysis was used to summarize the overall test performance. The pooled sensitivity for AFU was 0.72 (95 % confidence interval (CI) 0.69–0.76), while the pooled specificity was 0.78 (95 % CI 0.74–0.81). DOR was 10.26 (95 % CI 5.99–17.59), and the area under the curve (AUC) was 0.8125. AFU had great value for the diagnosis of HCC as a serum marker.     

Diagnostic performance of microRNAs expression in prostate cancer

MicroRNAs (miRNAs) have been proposed as ideal diagnostic indicators of prostate cancer (CaP). However, previous studies have reported conflicting results. Therefore, we conducted this meta-analysis to assess the potential diagnostic value of miRNAs for CaP. A systematic literature search was conducted in PubMed and other databases. Results from different studies were pooled using random effects models. The pooled sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to evaluate the overall test performance. Between-study heterogeneity was tested using the chi-squared test and the I ² test. Meta-regression and subgroup analyses were performed to explore the potential sources of heterogeneity. Fifty-eight studies from ten articles, including 669 patients with CaP and 404 controls composed of healthy individuals and patients with benign prostatic hyperplasia (BPH), were included in this meta-analysis. The pooled SEN and SPE were 0.74 (95 % confidence interval (CI) 0.70–0.78) and 0.73 (95 % CI 0.70–0.76), respectively. The pooled PLR was 2.7 (95 % CI 2.4–3.1); NLR was 0.35 (95 % CI 0.30–0.42); and DOR was 8 (95 % CI 6–10). The pooled AUC was 0.79 (95 % CI 0.76–0.83). Subgroup analyses indicated that multiple miRNAs yielded a better diagnostic accuracy. This systematic review suggests that miRNA analysis can significantly improve the overall accuracy of CaP diagnosis. Moreover, using multiple miRNA-based assays could achieve significantly higher accuracy in diagnosing CaP than single miRNA-based assays.     

外周血GPC3在肝细胞癌临床诊断中的价值

目的 探讨血清磷脂酰肌醇蛋白聚糖3(glypican-3,GPC3)蛋白和外周血GPC3 mRNA及其联合检测在肝细胞癌（hepatocellular carcinoma,HCC）中的诊断价值。方法 采用免疫组化法检测1例肝癌组织标本中GPC3的表达情况。检索PubMed、Web of Science、Embase和Cochrane library数据库中关于GPC3诊断HCC的文献,根据纳入和排除标准筛选文献,对纳入文献进行数据提取和质量评价,采用MetaDisc 1.4软件进行Meta分析,计算合并的诊断评估指标,绘制综合受试者工作特征（summary receiver operating characteristic,SROC）曲线评估其诊断效能。结果 免疫组化结果显示肝癌组织中特异性表达GPC3。进一步纳入19篇文献（其中血清GPC3蛋白16篇,外周血GPC3 mRNA 5篇）评价外周血中GPC3分子对HCC的诊断效能,结果显示,单独血清GPC3蛋白诊断HCC的合并敏感度、特异度、SROC曲线下面积分别为0.62(95%CI:0.60～0.64)、0.67(95%CI:0.65...     

Identification of Circular RNA hsa-circ-0006969 as a Novel Biomarker for Breast Cancer

Background: To investigate the characteristics of circular RNA hsa-circ-0006969 in breast cancer and identify it as a novel biomarker for breast cancer. Methods: Three breast cancer (BC) patient tissues were selected to perform human circRNA microarray analysis. GeneSpring 13.0 (Agilent) software was applied for analyzing the data. Another 116 BC patients were recruited for verification. Hsa-circ-0006969 was found as a potential circRNA for BC diagnostic biomarker. The structure of hsa-circ-0006969 was predicted by circPrimer1.2 software. MiRanda v3.3, RNA hybrid 2.1, and Cytoscape 3.6.0 were used for predicting the networks of circRNA-miRNA. T-test, Curve regression, and ROC analysis were applied to certify the diagnostic values of hsa-circ-0006969. Using SPSS25.0 software to perform the Statistical analysis. Results: 546 higher expression and 1475 lower expression circRNAs were identified. Four circRNAs were filtrated for further verification. Hsa-circ-0006969 was significantly low expressed in BC tissues and peripheral blood. Hsa-circ-0006969 was confirmed as higher diagnostic correlation with BC tissues (AUC = 0.965) and peripheral blood (AUC = 0.842), with Grade 1 (AUC = 0.639), ER-positive (AUC = 0.612), TNM I (AUC = 0.693), TNM II (AUC = 0.712), TNM III (AUC = 0.757), TNM early stage(I, II) (AUC = 0.709). Hsa-circ-0006969 presented more effective diagnostic values for tumor metastasis (AUC = 0.784) compared with CA153 (AUC = 0.752). Conclusion: Hsa-circ-0006969 could be a novel biomarker for the diagnosis and treatment of BC.     

Diagnostic value of microRNAs in discriminating malignant thyroid nodules from benign ones on fine-needle aspiration samples

Many studies have suggested that microRNAs (miRNAs) might serve as novel diagnostic indicators of thyroid cancer (TC). However, inconsistent results have also been reported. This meta-analysis was conducted to assess the diagnostic value of miRNAs in discriminating malignant thyroid nodules from benign ones on fine-needle aspiration samples. A systematic literature search for relevant literature published up to April 5, 2014 was conducted in PubMed, Embase, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biological Medicine (CBM) databases. Data from different studies were pooled to estimate the summary sensitivity (SEN), specificity (SPE), positive likelihood ratios (PLR), negative likelihood ratios (NLR), diagnostic odds ratio (DOR), using the random-effect model. Summary receiver operator characteristic curves (SROCs) were plotted and areas under the SROC curve (AUC) were calculated to evaluate the overall test performance. Between-study heterogeneity was tested using the Q tests and the I ² statistics. Potential sources of heterogeneity were analyzed through subgroup analyses and meta-regression. Deeks’ funnel plot asymmetry test was performed to evaluate publication bias. All analyses were performed using STATA 12.0 software. Eighteen studies from 7 articles, including 543 patients with malignant thyroid nodules (n?=?266) and benign ones (n?=?277), were included in this meta-analysis. The pooled SEN was 0.77 (95 % CI: 0.70–0.83), SPN was 0.75 (95 % CI: 0.68–0.81), PLR was 3.1 (95 % CI: 2.4–4.0), NLR was 0.30 (95 % CI: 0.23–0.39), DOR was 10 (95 % CI: 7–16), and AUC was 0.83 (95 %CI: 0.79–0.86). Subgroup analyses indicated that multiple miRNAs assays showed a higher diagnostic accuracy than single miRNA assays. In conclusion, this meta-analysis suggests that miRNAs analysis can significantly improve diagnostic accuracy for differentiating malignant thyroid nodules from benign indeterminate ones on fine-needle aspiration (FNA) samples. With further confirmation, multiple miRNAs assays may play a critical role as a complement to fine-needle aspiration biopsy (FNAB).