Sun Lina, Han Yanan, Wang Hua, Liu Huanyu, Liu Shan, Yang Hongbin, Ren Xiaoxia, Fang Ying
Xi'an Children's Hospital, Shaanxi Research Institute for Pediatric Diseases, The Affiliated Children's Hospital of Xi'an Jiaotong University and National Regional Medical Center for Children (Northwest), Xi'an 710003, China.
J Int Med Res. 2022 Apr;50(4):3000605221089503. doi: 10.1177/03000605221089503.
The clinical importance of aberrantly expressed microRNAs (miRNAs) in diagnosing inflammatory bowel disease (IBD) has not been well established, so was investigated in this systematic review and meta-analysis.
Articles in online databases from inception to March 17, 2021 were retrieved. Random effects meta-analysis was used to obtain sensitivity, specificity, positive (PLRs) and negative likelihood ratios (NLRs), diagnostic odds ratios (DORs), and areas under the curve (AUC) with 95% confidence intervals (CI) for IBD diagnosis.
Of 117 studies reporting altered miRNA expression in IBD included in the systematic review, 15 involving 937 patients with IBD and 707 controls, 22 miRNAs, and two miRNA panels were eligible for meta-analysis. Pooled analyses showed a moderate diagnostic accuracy for miRNAs in the IBD diagnosis, with a sensitivity of 0.80 (95% CI: 0.79-0.82), specificity of 0.84 (95% CI: 0.82-0.86), DOR of 21.19 (95% CI: 13.90-32.31), and AUC of 0.89. Subgroup analyses revealed a better performance in patients with ulcerative colitis (AUC, 0.93) than Crohn's disease (AUC, 0.84). Consistent upregulation of miR-21, miR-16, and miR-192 in blood with a high-moderate diagnostic accuracy was found in at least two studies.
These findings suggest miRNAs are credible diagnostic biomarkers in IBD.
异常表达的微小RNA(miRNA)在诊断炎症性肠病(IBD)中的临床重要性尚未完全明确,因此本系统评价和荟萃分析对其进行了研究。
检索自建库至2021年3月17日在线数据库中的文章。采用随机效应荟萃分析来获取IBD诊断的敏感性、特异性、阳性似然比(PLR)和阴性似然比(NLR)、诊断比值比(DOR)以及曲线下面积(AUC)和95%置信区间(CI)。
在系统评价纳入的117项报告IBD中miRNA表达改变的研究中,15项研究涉及937例IBD患者和707例对照、22种miRNA以及两个miRNA检测板,符合荟萃分析的条件。汇总分析显示miRNA在IBD诊断中具有中等诊断准确性,敏感性为0.80(95%CI:0.79 - 0.82),特异性为0.84(95%CI:0.82 - 0.86),DOR为21.19(95%CI:13.90 - 32.31),AUC为0.89。亚组分析显示,溃疡性结肠炎患者(AUC,0.93)的表现优于克罗恩病患者(AUC,0.84)。至少两项研究发现血液中miR - 21、miR - 16和miR - 192持续上调,具有中高度诊断准确性。
这些发现表明miRNA是IBD中可靠的诊断生物标志物。