Abstract
Objective: Recent studies indicated sputum miRNAs may provide a promising approach for non-small cell lung cancer (NSCLC) diagnosis. But some results were still inconsistent. So, we performed meta-analysis to evaluate the diagnostic role of sputum miRNAs for the detection of NSCLC.Methods: Eligible studies that estimated the diagnostic accuracy of sputum miRNAs in NSCLC were searched in Pubmed, Embase and Web of Science and Chinese National Knowledge Infrastructure (CNKI). Data from the eligible studies were collected and pooled; sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratios, weighted symmetric summary ROC curve and the area under the curve (AUC) were calculated by bi-variate random effects model. The between-study heterogeneity was evaluated by Q test and I2 statistics.Results: 30 studies from 16 articles were included for analysis. The overall analysis yielded the sensitivity of 0.77 (95% CI: 0.73–0.81) and specificity of 0.87 (95% CI: 0.83–0.90), with an area under the SROC curve (AUC) of 0.89 (95% CI: 0.86–0.91). Subgroup analysis revealed the diagnostic accuracy in multiple miRNAs studies was higher than single miRNA (the sensitivity, specifcity and an AUC of multiple miRNAs were 0.76, 0.88 and 0.90; and for single miRNA, it was 0.74, 0.74, and 0.80). The diagnostic performance in early stage NSCLC was also very high (the sensitivity, specifcity and an AUC of stage I/II was 0.76, 0.88 and 0.91; and for stage I, it was 0.79, 0.85, and 0.87). We also found miR-210, miR-21, miR-31 and miR-126-3p might serve as potential biomarkers for lung cancer.Conclusion: Sputum miRNAs was useful noninvasive biomarkers for NSCLC diagnosis.
Treatment selection of early stage non-small cell lung cancer: the role of the patient in clinical decision making
