环状RNA在结直肠癌中诊断价值的Meta分析

目的 系统性评价环状RNA（circRNA）诊断结直肠癌（CRC）的价值。方法 根据纳排标准，检索PubMed、EMBASE、CNKI等数据库收集文献；诊断试验质量评价工具（QUADAS-2）评价研究质量和偏倚；经Stata12.0合并诊断效应指标，并进行亚组分析、敏感度分析和Meta回归分析探讨研究间异质性。结果 共纳入17项研究，包含1873例CRC和1573例非癌对照患者。circRNA在CRC诊断中的总敏感度、特异性和曲线下面积（AUC）分别达0.79（95%CI: 0.76~0.81）、0.69（95%CI: 0.64~0.73）和0.81。亚组分析发现血清来源的circRNA分析检测（AUC=0.89, DOR=16.79）诊断CRC效能高于血浆（AUC=0.79, DOR=7.08）和组织（AUC=0.76, DOR=6.87）；致癌性的circRNA表达谱诊断CRC效能高于抑癌性的circRNA（AUC: 0.81 vs. 0.76; DOR: 8.54 vs. 6.21）；基于参考基因GAPDH的circRNA分析与整体诊断效能相当。结论 异常表达的circRNA用于诊断CRC具有较高的价值，可作为较好的分子指标用于CRC的辅助诊断。

Diagnostic Value of Circular RNAs for Colorectal Cancer: A Meta-analysis

Objective To systematically assess the diagnostic efficacy of circRNA in detecting CRC. Methods Eligible studies were obtained by searching the databases, such as PubMed, EMBASE, CNKI, etc. in line with the inclusion and exclusion criteria. Study quality and bias were judged by QUADAS-2 tool. The overall effect size, including pooled diagnostic parameters, was combined based on STATA 12.0 software. The causes of heterogeneity were investigated by conducting the subgroup, sensitivity and metaregression analyses. Results We included 17 eligible studies which contained 1873 CRC cases and 1573 paired controls. For CRC detection, circRNA expression harbored a pooled sensitivity, specificity and AUC of 0.79 (95%CI: 0.76-0.81), 0.69 (95%CI: 0.64-0.73) and 0.81, respectively. Subgroup analysis showed that serum-derived circRNA testing (AUC=0.89, DOR=16.79) harbored higher diagnostic efficacy than plasma (AUC=0.79, DOR=7.08) and tissue (AUC=0.76, DOR=6.87); oncogenic circRNAs achieved higher diagnostic capacity in detecting CRC than the anti-cancer circRNAs (AUC: 0.81 vs. 0.76; DOR: 8.54 vs. 6.21); however, circRNA testing quantified based on GAPDH showed comparable diagnostic capacity with the overall pooled effect. Conclusion Abnormally-expressed circRNAs have relatively high diagnostic efficacy in diagnosing CRC and may be rated as auxiliary biomarkers for CRC detection.