Utility of DWI with quantitative ADC values in ovarian tumors: a meta-analysis of diagnostic test performance

Background Diffusion-weighted imaging (DWI) and quantitative apparent diffusion coefficient (ADC) values are widely used in the differential diagnosis of ovarian tumors. Purpose To assess the diagnostic performance of quantitative ADC values in ovarian tumors. Material and Methods PubMed, Embase, the Cochrane Library, and local databases were searched for studies assessing ovarian tumors using quantitative ADC values. We quantitatively analyzed the diagnostic performances for two clinical problems: benign vs. malignant tumors and borderline vs. malignant tumors. We evaluated diagnostic performances by the pooled sensitivity and specificity values and by summary receiver operating characteristic (SROC) curves. Subgroup analyses were used to analyze study heterogeneity. Results From the 742 studies identified in the search results, 16 studies met our inclusion criteria. A total of ten studies evaluated malignant vs. benign ovarian tumors and six studies assessed malignant vs. borderline ovarian tumors. Regarding the diagnostic accuracy of quantitative ADC values for distinguishing between malignant and benign ovarian tumors, the pooled sensitivity and specificity values were 0.91 and 0.91, respectively. The area under the SROC curve (AUC) was 0.96. For differentiating borderline from malignant tumors, the pooled sensitivity and specificity values were 0.89 and 0.79, and the AUC was 0.91. The methodological quality of the included studies was moderate. Conclusion Quantitative ADC values could serve as useful preoperative markers for predicting the nature of ovarian tumors. Nevertheless, prospective trials focused on standardized imaging parameters are needed to evaluate the clinical value of quantitative ADC values in ovarian tumors.

Download Full-text

The diagnostic value of EBV-DNA and EBV-related antibodies detection for nasopharyngeal carcinoma: a meta-analysis

Cancer Cell International ◽

10.1186/s12935-021-01862-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Weixing Liu ◽

Gui Chen ◽

Xin Gong ◽

Yingqi Wang ◽

Yaoming Zheng ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Test Performance ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Control Group ◽

Summary Receiver Operating Characteristic ◽

Ebv Dna ◽

The Difference ◽

Sensitivity Specificity

Abstract Background Numerous individual studies have investigated the diagnostic value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection for nasopharyngeal carcinoma (NPC), but the conclusions remain controversial. This meta-analysis aimed to determine the value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection in the diagnosis of NPC. Methods PROSPERO registration number: CRD42019145532. PubMed, EMBASE, Cochrane Library, and Chinese data libraries (Wanfang, CNKI, and CBM) were searched up to January 2019. The pooled sensitivity, specificity, and positive likelihood, negative likelihood, and diagnostic odds ratios were conducted in this meta-analysis. Summary receiver operating characteristic curves evaluated the test-performance global summary. Publication bias was examined by Deek’s funnel plot asymmetry test. Results Forty-seven studies with 8382 NPC patients (NPC group) and 15,089 individuals without NPC (Control group) were included in this meta-analysis. The sensitivity, specificity, positive likelihood (+ LR), negative likelihood (-LR), DOR and AUC of EBV-DNA in diagnosis of NPC were: 0.76 (95% CI 0.73–0.77), 0.96 (95% CI 0.95–0.97), 14.66 (95% CI 9.97–21.55), 0.19 (95% CI 0.13–0.28), 84 (95% CI 50.45–139.88), 0.96 (SE: 0.001), and 0.55 (95% CI 0.54–0.57), 0.96 (95% CI 0.96–0.97), 12.91 (95% CI 9.55–17.45), 0.35 (95% CI 0.29–0.43), 39.57 (95% CI 26.44–59.23), 0.94 (SE: 0.002) for the EA-IgA, and 0.85 (95% CI 0.84–0.85), 0.89 (95% CI 0.88–0.89), 6.73 (95% CI5.38–8.43), 0.17 (95% CI 0.12–0.23), 43.03 (95% CI 31.51–58.76), 0.93 (SE: 0.007) for the VCA-IgA, and 0.86 (95% CI 0.85–0.88), 0.87 (95% CI 0.88–0.90), 7.55 (95% CI 5.79–9.87), 0.16 (95% CI 0.13–0.19), 50.95 (95% CI 34.35–75.57), 0.94 (SE: 0.008) for the EBNA1-IgA, and 0.70 (95% CI 0.69–0.71), 0.94 (95% CI 0.94–0.95), 9.84 (95% CI 8.40–11.54), 0.25 (95% CI 0.21–0.31), 40.59 (95% CI 32.09–51.35), 0.95 (SE: 0.005) for the Rta-IgG. The EBV-DNA had larger AUC compared with other EBV-based antibodies (P < 0.05), while the difference between EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG was not statistically significant (P > 0.05). Conclusions EBV-DNA, VCA-IgA, EBNA1-IgA and Rta-IgG detection have high accuracy in early diagnosis NPC. In addition, EBV-DNA detection has the higher diagnosis accuracy in NPC. On the other hand, EA-IgA is suitable for the diagnosis but not NPC screening.

Download Full-text

Diagnostic performance of lung ultrasound for transient tachypnea of the newborn: A meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0248827 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248827

Author(s):

Lili He ◽

Yinghua Sun ◽

Wei Sheng ◽

Qiong Yao

Keyword(s):

Sensitivity And Specificity ◽

Diagnostic Performance ◽

Large Scale ◽

Lung Ultrasound ◽

Meta Analysis ◽

Characteristic Curve ◽

Relevant Literature ◽

Cochrane Library ◽

Lower Sensitivity ◽

Summary Receiver Operating Characteristic

Several recent studies demonstrated that lung ultrasound could achieve desired diagnostic accuracy for transient tachypnea of the neonate (TTN). However, the diagnostic performance of lung ultrasound for TTN has not been systematically studied to date. This meta-analysis aimed to investigate the performance of lung ultrasound in diagnosing TTN. The relevant literature was searched in PubMed, Medline, the Cochrane Library, and Embase databases without any restriction in terms of language and time until January 31, 2021. Studies that assessed the diagnostic performance of lung ultrasound for TTN were included. Seven studies with 1514 participants were summarized. The lung ultrasound provided more accurate performance for diagnosing TTN with pooled sensitivity and specificity of 0.67 [95% confidence interval (CI) = 0.63–0.71] and 0.97 (95% CI = 0.95–0.98), respectively. A higher summarized area under the summary receiver operating characteristic curve was observed as 0.9906. Lower sensitivity and area under the curve (AUC) of B-lines for TTN were observed as 0.330 (95% CI = 0.27–0.38) and 0.5000, respectively. Lung ultrasound provided highly accurate AUC, sensitivity, and specificity in detecting TTN. Large-scale studies are warranted in the future to confirm these results.

Download Full-text

Circulating long non-coding RNAs as potential biomarkers for stomach cancer: A systematic review and meta-analysis

10.21203/rs.3.rs-81358/v1 ◽

2020 ◽

Author(s):

Fang Cao ◽

Yongwei Hu ◽

Zaichang Chen ◽

Wei Han ◽

Weijie Lu ◽

...

Keyword(s):

Stomach Cancer ◽

Meta Analysis ◽

Area Under The Curve ◽

Cochrane Library ◽

Clinical Value ◽

Summary Receiver Operating Characteristic ◽

Non Coding Rna ◽

Diagnostic Values ◽

Meta Regression Analysis ◽

Characteristic Area

Abstract Background: Recent researches have suggested that long non-coding RNA (lncRNA) is involved in the tumorigenesis and development of stomach cancer (SC). This meta-analysis aimed to identify the diagnostic performance of circulating lncRNAs in SC.Methods: All relevant studies were systematically searched through PubMed, Web of Science, Cochrane Library and EMBASE databases. The diagnostic values of lncRNAs were mainly assessed by pooled sensitivity (SEN), specificity (SPE), and summary receiver operating characteristic area under the curve (SROC AUC). Meta-DiSc 1.4, Review Manager 5.3 and STATA 12.0 were used for statistical analysis. Results: A total of 42 eligible studies were included in this meta-analysis. The pooled SEN, SPE, and AUC were 0.78 (95%CI: 0.75-0.81), 0.75 (95%CI: 0.71-0.78), and 0.83 (95%CI: 0.80-0.86) respectively, suggesting that the lncRNAs test had a high accuracy for the diagnosis of SC. Obvious heterogeneity might come from the type of lncRNA through subgroup and meta-regression analysis. Fagan diagram showed the clinical value of lncRNAs test in SC. Conclusions: Abnormal expression of circulating lncRNAs exhibits a high efficacy for diagnosing SC, which is promising in clinical application.

Download Full-text

The diagnostic performance of 18F-FDG PET/CT and MRI in differentiating benign and malignant ovarian tumors: an indirect comparative analysis

10.21203/rs.3.rs-402687/v1 ◽

2021 ◽

Author(s):

Xianwen Hu ◽

Dandan Li ◽

Zhigang Liang ◽

Yan Liao ◽

Ling Yang ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Fdg Pet ◽

Diagnostic Performance ◽

Malignant Tumors ◽

Meta Analysis ◽

Ovarian Tumors ◽

Scanning Time ◽

Pet Ct ◽

Fdg Pet Ct ◽

Ct And Mri

Abstract Objective: To compare the value of Fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) and magnetic resonance imaging(MRI) in differentiating benign and malignant ovarian tumors.Material and Methods: Retrieved the research on the diagnostic performance of MRI or 18F-FDG PET/CT in identifying benign and malignant ovarian tumors published in PubMed and Embase from January 2000 to January 2021. Two authors independently extracted the data of the characteristics of each study. If the data of the study report can be used to construct a 2X2 contingency table comparing 18F-FDG PET/CT and MRI, these studies were selected. The Quality Assessment of Diagnostic Accuracy Studies were used to evaluate the quality of the studies. According to the sensitivity and specificity of 18F-FDG PET/CT and MRI, forest plots is generated.Results：A total of 27 articles including 1118F-FDG PET/CT studies and 17 MRI studies on the differentiation of benign and malignant ovarian or accessory tumors were included for this meta-analysis. The pooled sensitivity and specificity for 18F-FDG PET/CT in differentiating benign and malignant ovarian tumors were 0.92 (95% CI, 0.86-0.96) and 0.86 (95% CI, 0.79-0.91), respectively, and the pooled sensitivity and specificity for MRI were 0.92 (95% CI: 0.89-0.95) and 0.85 (95% CI: 0.79-0.89), respectively.Conclusion：MRI and 18F-FDG PET/CT have the same diagnostic performance in the differential diagnosis of ovarian benign and malignant tumors. However, MRI is more worthy of clinical application because of its lack of radiation, shorter scanning time, and lower medical costs.

Download Full-text

Clinical Value of ctDNA in Hematological Malignancies (Lymphomas, Multiple Myeloma, Myelodysplastic Syndrome, and Leukemia): A Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.632910 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xiangyu Tan ◽

Han Yan ◽

Lei Chen ◽

Yuyang Zhang ◽

Chunyan Sun

Keyword(s):

Disease Progression ◽

Sensitivity And Specificity ◽

Hematological Malignancies ◽

Meta Analysis ◽

Progression Free Survival ◽

Circulating Tumor Dna ◽

Detection Sensitivity ◽

Cochrane Library ◽

Clinical Value ◽

Invasive Approach

Background: Circulating tumor DNA (ctDNA) has offered a minimally invasive approach for the detection and measurement of cancer. However, its diagnostic and prognostic value in hematological malignancies remains unclear.Materials and methods: Pubmed, Embase, and Cochrane Library were searched for relating literature. Diagnostic accuracy variables and disease progression prediction data were pooled by the Meta-Disc version 1.4 software. Review Manager version 5.4 software was applied for prognostic data analysis.Results: A total of 11 studies met our inclusion criteria. In terms of diagnosis, the pooled sensitivity and specificity were 0.51 (95% confidence intervals (CI) 0.38–0.64) and 0.96 (95% CI 0.88–1.00), respectively. The AUSROC (area under the SROC) curve was 0.89 (95%CI 0.75–1.03). When it comes to the prediction of disease progression, the overall sensitivity and specificity was 0.83 (95% CI 0.67–0.94) and 0.98 (95% CI 0.93–1.00), respectively. Moreover, a significant association also existed between the presence of ctDNA and worse progression-free survival (HR 2.63, 95% CI 1.27–5.43, p = 0.009), as well as overall survival (HR 2.92, 95% CI 1.53–5.57, p = 0.001).Conclusions: The use of ctDNA in clinical practice for hematological malignancies is promising, as it may not only contribute to diagnosis, but could also predict the prognosis of patients so as to guide treatment. In the future, more studies are needed to realize the standardization of sequencing techniques and improve the detection sensitivity of exploration methods.

Download Full-text

The meta-analysis for ideal cytokines to distinguish the latent and active TB infection

BMC Pulmonary Medicine ◽

10.1186/s12890-020-01280-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Zhenhong Wei ◽

Yuanting Li ◽

Chaojun Wei ◽

Yonghong Li ◽

Hui Xu ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Diagnostic Performance ◽

Meta Analysis ◽

Characteristic Curve ◽

Cochrane Library ◽

World Population ◽

Summary Receiver Operating Characteristic ◽

Discriminative Ability ◽

Cytokine Detection ◽

Ifn Γ

Abstract Background One forth whole-world population is infected with Mycobacterium tuberculosis (Mtb), but 90% of them are asymptotic latent infection without any symptoms but positive result in IFN-γ release assay. There is lack of ideal strategy to distinguish active tuberculosis (TB) and latent tuberculosis infection (LTBI). Some scientist had focused on a set of cytokines as biomarkers besides interferon- gamma (IFN-γ) to distinguish active TB and LTBI, but with considerable variance of results. This meta-analysis aimed to evaluate the overall discriminative ability of potential immune molecules to distinguish active TB and LTBI. Methods PubMed, the Cochrane Library, and Web of Science databases were searched to identify studies assessing diagnostic roles of cytokines for distinguishing active TB and LTBI published up to August 2018. The quality of enrolled studies was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The pooled diagnostic sensitivity and specificity of each cytokine was calculated by using Meta-DiSc software. Area under the summary receiver operating characteristic curve (AUC) was used to summarize the overall diagnostic performance of each biomarker. Results Fourteen studies with 982 subjects met the inclusion criteria, including 526 active TB and 456 LTBI patients. Pooled sensitivity, specificity and AUC for discriminating between active TB and LTBI were analyzed for IL-2 (0.87, 0.61 and 0.9093), IP-10 (0.77, 0.73 and 0.8609), IL-5 (0.64, 0.75 and 0.8533), IL-13 (0.75, 0.71 and 0.8491), IFN-γ (0.67, 0.75 and 0.8031), IL-10 (0.68, 0.74 and 0.7957) and TNF-α (0.67, 0.64 and 0.7783). The heterogeneous subgroup analysis showed that cytokine detection assays, TB incidence, and stimulator with Mtb antigens are main influence factors for their diagnostic performance. Conclusions The meta-analysis showed cytokine production could assist the distinction between active TB and LTBI, IL-2 with the highest overall accuracy. No single biomarker is likely to show sufficiently diagnostic performance due to limited sensitivity and specificity. Further prospective studies are needed to identify the optimal combination of biomarkers to enhanced diagnostic capacity in clinical practice.

Download Full-text

Potential Values Of Circulating Tumor Cell For Detection Of Recurrence In Patients Of Thyroid Cancer:A Diagnostic Meta-analysis

10.21203/rs.3.rs-64880/v1 ◽

2020 ◽

Author(s):

Ming-Xing Liang ◽

Yin-Jiao Fei ◽

Kai Yang ◽

Wen-Juan Tang ◽

Xin-Hui Cao ◽

...

Keyword(s):

Thyroid Cancer ◽

Tumor Cell ◽

Test Performance ◽

Meta Analysis ◽

Characteristic Curve ◽

Circulating Tumor Cell ◽

Thyroid Stimulating Hormone ◽

Diagnostic Methods ◽

Cochrane Library ◽

Summary Receiver Operating Characteristic

Abstract purpose Several studies have reported that circulating tumor cell (CTC) is a promising marker for the diagnosis of thyroid cancer (TC) with recurrence or distant metastasis (DMs). However, some studies emerged with conflicting results. Therefore, we provide a meta-analysis to evaluate the diagnostic performance of CTC for detection of recurrence in patients of TC. Methods We searched PubMed, Web of Science, Cochrane library with the keywords “thyroid cancer” and “circulating tumor cells”. Data extraction and risk of bias assessment were performed independently by two reviewers. The summary receiver operating characteristic curve (SROC) and other parameters were adopted to summarize the overall test performance. The sensitivity of CTCs in the detection of recurrent TC was reviewed. All analyses were performed by STATA 12.0 and Meta-disc software. Results For CTCs expressing epithelial cell adhesion molecule (EpCAM), seven studies were included in our meta-analysis. Pooled sensitivity, specificity, and diagnostic odds ratio were 0.71 (95% CI: 0.63–0.78), 0.89 (95% CI: 0.84–0.94), and 26.75 (95% CI: 9.11–78.53); 0.78 (95% CI: 0.65–0.89), 0.88 (95% CI: 0.76–0.96), and 40.01 (95% CI: 10.49–152.63) for CTCs expressing thyroid stimulating hormone receptor (TSHR). The area under the SROC for EpCAM and TSHR were both 0.91. Conclusion CTC was a reliable marker for the diagnosis of TC patients with recurrence and DMs, and the sensitivity of CTCs expressing TSHR was higher than that of EpCAM. Additional research is warranted in order to establish uniformity in international guidelines, make up the drawbacks of conventional diagnostic methods and to prevent futile surgery.

Download Full-text

Age-adjusted quick Sequential Organ Failure Assessment score for predicting mortality and disease severity in children with infection: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-01271-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sohyun Eun ◽

Haemin Kim ◽

Ha Yan Kim ◽

Myeongjee Lee ◽

Go Eun Bae ◽

...

Keyword(s):

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Disease Severity ◽

Sensitivity And Specificity ◽

Meta Analysis ◽

Characteristic Curve ◽

Cochrane Library ◽

Summary Receiver Operating Characteristic ◽

Assessment Score ◽

Failure Assessment

AbstractWe assessed the diagnostic accuracy of the age-adjusted quick Sequential Organ Failure Assessment score (qSOFA) for predicting mortality and disease severity in pediatric patients with suspected or confirmed infection. We conducted a systematic search of PubMed, EMBASE, the Cochrane Library, and Web of Science. Eleven studies with a total of 172,569 patients were included in the meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio of the age-adjusted qSOFA for predicting mortality and disease severity were 0.69 (95% confidence interval [CI] 0.53–0.81), 0.71 (95% CI 0.36–0.91), and 6.57 (95% CI 4.46–9.67), respectively. The area under the summary receiver-operating characteristic curve was 0.733. The pooled sensitivity and specificity for predicting mortality were 0.73 (95% CI 0.66–0.79) and 0.63 (95% CI 0.21–0.92), respectively. The pooled sensitivity and specificity for predicting disease severity were 0.73 (95% CI 0.21–0.97) and 0.72 (95% CI 0.11–0.98), respectively. The performance of the age-adjusted qSOFA for predicting mortality and disease severity was better in emergency department patients than in intensive care unit patients. The age-adjusted qSOFA has moderate predictive power and can help in rapidly identifying at-risk children, but its utility may be limited by its insufficient sensitivity.

Download Full-text

Diagnostic tests for Schistosomiasis for low prevalence settings: a systematic review and Meta-Analysis

10.1101/2021.05.05.21256678 ◽

2021 ◽

Author(s):

Michel Thierry Vaillant ◽

Fred Philippy ◽

Jessica Barre ◽

Dmitry Bulaev ◽

Amadou Djirmay Garba

Keyword(s):

Sensitivity And Specificity ◽

Diagnostic Tests ◽

Residual Disease ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Cochrane Library ◽

Reference Standard ◽

Summary Receiver Operating Characteristic ◽

Good Ability ◽

Number Of Patients

Abstract Background Tests for diagnosing schistosomiasis in areas where prevalence is low due to control programme of the disease should be suffiently sensitive to detect the residual disease. If they had sufficient diagnostic accuracy they could replace conventional microscopy as they provide a quicker answer and are easier to use. Objectives To compare sensitivity and specificity of new tests, especially rapid diagnostic tests (RDTs), with regard to a certain reference test. Search methods We searched the electronic databases Pubmed, EMBASE, the Cochrane Library and LILACS up to February 2021. Furthermore we searched results from the previous meta-analyses. Selection criteria We included studies that used microscopy as the reference standard: for S. haematobium, microscopy of urine prepared by filtration, centrifugation, or sedimentation methods; and for S. mansoni, microscopy of stool by Kato-Katz thick smear. Data collection and analysis Two review authors independently extracted data, assessed quality of the data using QUADAS-2, and performed meta-analysis where appropriate. Grading of evidence was done with the GRADE methodology by using GradePro. Using the variability of test thresholds, we used a bayesian bivariate random-effects summary receiver operating characteristic model for all eligible tests. We investigated heterogeneity, and carried out sensitivity analyses where possible. Results for sensitivity and specificity are presented as percentages with 95% confidence intervals (CI). Main results The review gathered 203 articles stating a diagnostic test for the diagnosis of S. haematobium and S. mansoni out of which 114 entered the analyses. Microscopy of Urine filtration or Kato-Katz smears were used as the reference standard. Compared with Kato-Katz smears, AWE-SEA ELISA (Se=94%; Sp=64%) is comparable to CCA1 (Se=87%; Sp=60%). IgG ELISA (Se=93%; Sp=68%) has also a very good ability to detect true positive as well as CAA cassette (Se=73%; Sp=68%). For S. haematobium, proteinuria (Se=59%; Sp=83%) and haematuria (Se=74%; Sp=87%) reagent strips showed reasonably high specificities with a considerably better sensitivity for the haematuria test. Authors' conclusions There are interesting promising new diagnostic tests that were tested in field studies. However prevalences of the locations where these studies took place are variable and there are no specific study with a high number of patients in areas with low level of schistosomiasis infection.

Download Full-text

MicroRNA-21 as a diagnostic marker for hepatocellular carcinoma: A systematic review and meta-analysis

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.5.685 ◽

2019 ◽

Vol 35 (5) ◽

Cited By ~ 1

Author(s):

Juan Qu ◽

Jizhi Yang ◽

Ming Chen ◽

Lihong Cui ◽

Tianxi Wang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Systematic Review ◽

Sensitivity And Specificity ◽

Diagnostic Marker ◽

Meta Analysis ◽

Characteristic Curve ◽

Random Effect ◽

Random Effect Model ◽

Cochrane Library ◽

Summary Receiver Operating Characteristic

Background: MicroRNA-21 (miR-21) is one of the oncogenic miRNAs which may be a potential diagnostic biomarker for hepatocellular carcinoma (HCC). Methods: We systematically searched Medline, Embase, the Cochrane Library, ISI Web of Knowledge, Scopus from inception to August 15, 2018, and reference lists of identified primary studies. Two independent investigators extracted patient and study characteristics. The sensitivity and specificity of microRNA-21 for HCC detection and were analyzed with a random effect model. The area under summary receiver operating characteristic curve (AUC) was used to estimate overall test performance. Results: A total of 515 HCC patients, and 338 healthy or chronic hepatitis controls from six published studies were enrolled in this meta-analysis. All articles were published in English with moderate-to-high quality. The overall pooled sensitivity and specificity were 85.2% (73.3% to 88.4%) and 79.2% (68.4% to 87.0%), respectively. The AUC area was 0.89 (95% CI: 0.85-0.91). The studies had moderate heterogeneity (I2=70.11%). None of the subgroups investigated-ethnicity, controls, sample source-could account for the heterogeneity. Conclusion: MiR-21 is a helpful biomarker for early diagnosis of HCC. Nevertheless, the results of the test must be interpreted carefully in the context of medical history, erological tests and imaging examinations for HCC surveillance. doi: https://doi.org/10.12669/pjms.35.5.685 How to cite this:Qu J, Yang J, Chen M, Cui L, Wang T, Gao W, et al. MicroRNA-21 as a diagnostic marker for hepatocellular carcinoma: A systematic review and meta-analysis. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.685 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download Full-text