scholarly journals Diagnostic and prognostic significance of dysregulated expression of circular RNAs in osteosarcoma

2020 ◽  
Author(s):  
Chenghao Zhang ◽  
Jieyu He ◽  
Lin Qi ◽  
Zhixi Duan ◽  
Lu Wan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Disease Free Survival ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
Circular Rnas ◽  
Diagnostic Significance ◽  
Enneking Stage

Abstract Background Circular RNAs (circRNAs) have emerged as pivotal regulators in osteosarcoma tumorigenesis and progression, but their prognostic and diagnostic significance remain unclear. Herein, we aimed to perform an updated meta-analysis to explore the clinical, diagnostic and prognostic values of circRNAs in osteosarcoma. Methods Several databases, including PubMed, Web of Science, EMBASE, Scopus and Cochrane Library, were systematically searched up to Mar 10, 2020. Eligible studies regarding the relationship between circRNAs levels and clinicopathological, diagnostic and prognostic values in osteosarcoma patients were included in this study. Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to measure clinical characteristics, while hazard ratios (HRs) with 95% CIs were adopted to assess overall survival (OS) and disease-free survival (DFS). Results Overall, 26 relevant studies involving 1,652 patients with osteosarcoma were enrolled, with eighteen studies on clinicopathological parameters, ten on diagnosis and eighteen on prognosis. For clinical parameters, overexpression of oncogenic circRNAs was intimately correlated with larger tumor size (P <0.00001), advanced Enneking stage (P <0.00001), poor differentiation (P =0.0001), and distant metastasis (DM) (P <0.00001). In contrast, the downregulated circRNAs showed negative correlation with Enneking stage (P=0.002) and DM (P<0.0001). For the diagnostic values, the summary area under the curve (AUC) of circRNA for the discriminative efficacy between osteosarcoma patients and non-cancer counterparts was estimated to be 0.86 (95% CI: 0.83-0.89), with a weighted sensitivity of 0.80 (95% CI: 0.74-0.84), specificity of 0.80 (95%: 0.75-0.84), and diagnostic odds ratio (DOR) of 15.48 (10.85-22.10), respectively. For the prognostic significance, oncogenic circRNAs had poor OS (HR=1.92, 95% CI: 1.68-2.19) and DFS (HR=2.65, 95% CI: 2.02-3.49), while elevated expression of tumor-suppressor circRNAs were closely related to longer OS (HR=0.44, 95% CI: 0.28-0.69). Conclusions Taken together, our study showed that aberrantly expressed circRNA signatures could serve as potential predictive indicators in diagnosis and prognosis in patients with osteosarcoma.

scholarly journals Diagnostic and Prognostic Significance of Dysregulated Expression of Circular RNAs in Osteosarcoma

2020 ◽  
Author(s):  
Chenghao Zhang ◽  
Jieyu He ◽  
Lin Qi ◽  
Zhixi Duan ◽  
Lu Wan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Disease Free Survival ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
Circular Rnas ◽  
Diagnostic Significance ◽  
Enneking Stage

Abstract Background CircRNAs have emerged as pivotal regulators in osteosarcoma tumorigenesis and progression, but their prognostic and diagnostic significance remain unclear. Herein, we aimed to perform an updated meta-analysis to explore the clinical, diagnostic and prognostic values of circRNAs in osteosarcoma. Methods Several databases, including PubMed, Web of Science, EMBASE, Scopus and Cochrane Library, were systematically searched up to April 10, 2020. Eligible studies regarding the relationship between circRNAs levels and clinicopathological, diagnostic and prognostic values in osteosarcoma patients were included in this study. Pooled odds ratios with corresponding 95% confidence intervals were used to measure clinical characteristics, while hazard ratios with 95% CIs were adopted to assess overall survival (OS) and disease-free survival (DFS). Results Overall, 26 relevant studies involving 1,652 patients with osteosarcoma were enrolled, with eighteen studies on clinicopathological parameters, ten on diagnosis and eighteen on prognosis. For clinical parameters, overexpression of oncogenic circRNAs was intimately correlated with larger tumor size (P < 0.00001), advanced Enneking stage (P < 0.00001), poor differentiation (P = 0.0001), and distant metastasis (DM) (P < 0.00001). In contrast, the downregulated circRNAs showed negative correlation with Enneking stage (P = 0.002) and DM (P < 0.0001). For the diagnostic values, the summary area under the curve of circRNA for the discriminative efficacy between osteosarcoma patients and non-cancer counterparts was estimated to be 0.86 (95% CI: 0.83–0.89), with a weighted sensitivity of 0.80 (95% CI: 0.74–0.84), specificity of 0.80 (95%: 0.75–0.84), and diagnostic odds ratio of 15.48 (10.85–22.10), respectively. For the prognostic significance, oncogenic circRNAs had poor OS (HR = 1.92, 95% CI: 1.68–2.19) and DFS (HR = 2.65, 95% CI: 2.02–3.49), while elevated expression of tumor-suppressor circRNAs were closely related to longer OS (HR = 0.44, 95% CI: 0.28–0.69). Conclusions Taken together, our study showed that aberrantly expressed circRNA signatures could serve as potential biomarkers in diagnosis and prognosis in patients with osteosarcoma.

Diagnostic and prognostic values of circular RNAs for lung cancer: a meta-analysis

2020 ◽  
pp. postgradmedj-2019-137178
Author(s):  
Qian Yang ◽  
Lizhen Chen ◽  
Li Yang ◽  
Yuanshuai Huang
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
Circular Rnas ◽  
Lung Cancer Patients ◽  
Diagnostic Values

Circular RNAs (circRNAs) may serve as potential biomarkers for patients with lung cancer. The aim of this meta-analysis was to analyse the diagnostic, prognostic and clinicopathological values of circRNAs in lung cancer patients. A systematic search of PubMed, Embase, Web of Science, Scopus and the Cochrane Library databases was performed for relevant articles from inception to 29 January 2020. Pooled parameters including sensitivity, specificity and area under the curve (AUC) were used to assess the diagnostic performance, HRs and 95% CIs were used to evaluate overall survival (OS) and ORs were used to estimate clinicopathological parameters. 52 studies from 45 articles were enrolled in this study, including 17 on diagnosis and 35 on prognosis. For diagnostic values, circRNAs could discriminate lung cancer patients from the controls, with AUC of 0.83 (95% CI: 0.79 to 0.86), a relatively high sensitivity of 0.77 (95% CI: 0.73 to 0.81) and specificity of 0.75 (95% CI: 0.71 to 0.79). For prognostic significances, overexpression of 23 upregulated circRNAs was relevant to a poor prognosis (OS: HR=2.21, 95% CI: 1.96 to 2.49, p<0.001), and overexpression of 9 downregulated circRNAs was correlated with a favourable prognosis (OS: HR=0.62, 95% CI: 0.53 to 0.73, p<0.001). As for clinicopathological parameters, high expression of 23 upregulated circRNAs was associated with unfavourable clinicopathological features while 9 downregulated circRNAs proved the contrary. In conclusion, this study confirmed that circRNAs might serve as important biomarkers for diagnostic and prognostic values of lung cancer.

Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: A Meta-Analysis

2019 ◽  
Author(s):  
Xunlei Zhang ◽  
Wenjing Zhao ◽  
Yang Yu ◽  
Xue Qi ◽  
Li Song ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
Poor Overall Survival ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Inflammatory Parameters

Abstract Background: Systemic inflammatory parameters, such as the elevator PLR (platelet-lymphocyte ratio), have been found to be associated with the prognosis in gastric cancer (GC); however, the results remain controversial. So we aimed to evaluate the prognostic role of the PLR in gastric cancer by conducting this meta-analysis. Methods: We performed a systematic literature search in PubMed, Embase and the Cochrane Library. The hazard ratio (HR) /Odds Ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated. Results: A total of 38 studies (39 cohorts) with 23,317 GC patients were included in the final meta-analysis. The pooled results showed that elevated PLR was significantly associated with poor overall survival (OS) (HR: 1.37, 95% CI: 1.25-1.51, p < 0.001; I2= 82.10%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95%CI 1.22–1.90, P< 0.001, I2= 88.6%, Ph< 0.001) of GC patients. Furthermore, patients with elevated PLR had a higher risk of lymph node metastasis (OR = 1.33, 95% CI: 1.03–1.70, p=0.027), serosal invasion (T3 +T4) (OR = 1.58, 95% CI: 1.09–1.31, p=0.017) and increased advanced stage (III+IV) (OR = 1.37, 95% CI: 1.00–1.89, p=0.050). Conclusions: This meta-analysis demonstrated that elevated PLR was a prognostic factor for poor OS and DFS, and associated with clinicopathological parameters in patients with GC.

scholarly journals Prognostic value of lncRNA ROR expression in various cancers: a meta-analysis

2018 ◽  
Vol 38 (5) ◽  
Author(s):  
Renfu Lu ◽  
Junjian Chen ◽  
Lingwen Kong ◽  
Hao Zhu
Keyword(s):  
Prognostic Value ◽  
Meta Analysis ◽  
Clinical Stage ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
Advanced Clinical Stage ◽  
Non Coding Rna ◽  
Meta Analyses

Background: There is a dispute on the prognostic value of long non-coding RNA regulator of reprogramming (lncRNA ROR) in cancers. The purpose of the present study was to evaluate the prognostic significance of lncRNA ROR expression in human cancers. Methods: PubMed, Embase, and Cochrane Library were searched to look for relevant studies. The meta-analyses of prognostic and clinicopathological parameters (CPs) were conducted. Results: A total of ten studies were finally included into the meta-analysis. High lncRNA ROR expression was significantly associated with shorter overall survival (hazard ratio [HR] = 2.88, 95% confidence interval [CI] = 2.16–3.84, P<0.01) and disease-free survival (HR = 3.25, 95% CI = 2.30–4.60, P<0.01) compared with low lncRNA ROR expression. Besides, high lncRNA ROR expression was obviously related to more advanced clinical stage (P<0.01), earlier tumor metastasis (P=0.02), lymph node metastasis (P<0.01), and vascular invasion (P<0.01) compared with low lncRNA ROR expression. However, there was no significant correlation between lncRNA ROR expression and other CPs, including age (P=0.18), gender (P=0.33), tumor size (P=0.25), or tumor differentiation (P=0.13). Conclusion: High lncRNA ROR expression was associated with worse prognosis in cancers. LncRNA ROR expression could serve as an unfavorable prognostic factor in various cancers.

scholarly journals Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: An Updated Meta-Analysis

2020 ◽  
Author(s):  
Xunlei Zhang ◽  
Wenjing Zhao ◽  
Yang Yu ◽  
Xue Qi ◽  
Li Song ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
Poor Overall Survival ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Pre Treatment

Abstract Background: Pretreatment PLR (platelet-lymphocyte ratio), was reported to be associated with the prognosis in gastric cancer (GC), but the results remain inconclusive. This meta-analysis aimed to investigate the prognostic potential of the pre-treatment PLR in gastric cancer.Methods: We performed a systematic literature search in PubMed, Embase and the Cochrane Library to identify eligible publications. The hazard ratio (HR) /Odds Ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated.Results: A total of 49 studies (51 cohorts), collectting data from 28,929 GC patients, were included in the final analysis. The pooled results demonstrated that the elevated pre-treatment PLR was significantly associated with poor overall survival (OS) (HR: 1.37, 95% CI: 1.26-1.49, p < 0.001; I2= 79.90%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95%CI 1.22–1.90, P< 0.001, I2= 88.6%, Ph< 0.001). Furthermore, the patients with the elevated PLR had a higher risk of lymph node metastasis (OR = 1.17, 95% CI: 1.02–1.33, p=0.023), serosal invasion (T3 +T4) (OR = 1.34, 95% CI: 1.10–1.64, p=0.003) and increased advanced stage (III+IV) (OR = 1.20, 95% CI: 1.06–1.37, p=0.004).Conclusions: An elevated pre-treatment PLR was a prognostic factor for poor OS and DFS, and associated with poor clinicopathological parameters in GC patients .

scholarly journals A pair-wise meta-analysis highlights circular RNAs as potential biomarkers for colorectal cancer

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chen Li ◽  
Xinli He ◽  
Lele Zhang ◽  
Lanying Li ◽  
Wenzhao Zhao
Keyword(s):  
Colorectal Cancer ◽  
Diagnostic Accuracy ◽  
Cancer Progression ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Circular Rnas ◽  
Depth Of Invasion ◽  
Tumor Diameter

Abstract Background Circular RNAs (circRNAs) have emerged as a special subset of endogenous RNAs that are implicated in tumorigenesis and cancer progression. Herein we aim to carry out a meta-analysis to evaluate the clinicopathologic, diagnostic and prognostic significance of circRNA expression in colorectal cancer (CRC). Methods A systematic search of online databases was performed for original articles published in English, which investigated the diagnostic accuracy, prognostic utility, and clinicopathologic association of circRNA(s) in CRC. Data were strictly extracted and study bias was judged using the Quality Assessment for Studies of Diagnostic Accuracy II (QUADAS II) and Newcastle-Ottawa Scale (NOS) checklists. Results A total of 13 studies, involving 1430 patients with CRC, were included in the meta-analysis. The clinicopathologic study showed that abnormally expressed circRNAs were correlated with tumor diameter (P = 0.0350), differentiation (P = 0.0038), lymphatic metastasis (P = 0.0119), distant metastasis (P < 0.0001), TNM stage (P = 0.0002), and depth of invasion (P = 0.001) in patients with CRC. The summary area under the curve (AUC) of circRNA for the discriminative efficacy between patients with and without CRC was estimated to be 0.79, corresponding to a weighted sensitivity of 0.77 [95% confidence interval (CI): 0.74–0.79], specificity of 0.67 (95%CI: 0.64–0.70), and diagnostic odds ratio (DOR) of 7.52 (95%CI: 4.66–12.12). Survival analysis showed that highly expressed circRNAs were correlated with significantly worse overall survival (OS) [hazard ratio (HR) = 2.66, 95%CI: 2.03–3.50, P = 0.000; X2 = 4.34, P = 0.740, I2 = 0.0%], whereas lower expression of circRNAs was associated with prolonged OS (weighted HR = 0.30, 95%CI: 0.17–0.53, P = 0.000; X2 = 1.34, P = 0.909, I2 = 0.0%). Stratified analysis in circRNA expression status, and test matrix also showed robust results. Conclusion Abnormally expressed circRNAs may be auxiliary biomarkers facilitating CRC diagnosis, and promising prognostic biomarkers in predicting the survival of CRC patients.

scholarly journals Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: An Updated Meta-Analysis

2020 ◽  
Author(s):  
Xunlei Zhang ◽  
Wenjing Zhao ◽  
Yang Yu ◽  
Xue Qi ◽  
Li Song ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
Poor Overall Survival ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Inflammatory Parameters

Abstract Background Systemic inflammatory parameters, such as the elevator PLR (platelet-lymphocyte ratio), have been found to be associated with the prognosis in gastric cancer (GC); however, the results remain controversial. So we aimed to evaluate the prognostic role of the PLR in gastric cancer by conducting this meta-analysis. Methods We performed a systematic literature search in PubMed, Embase and the Cochrane Library. The hazard ratio (HR) /Odds Ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated. Results A total of 49 studies (51 cohorts) with 28,929 GC patients were included in the final meta-analysis. The pooled results showed that elevated PLR was significantly associated with poor overall survival (OS) (HR: 1.37, 95% CI: 1.26–1.49, p < 0.001; I2 = 79.90%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95%CI 1.22–1.90, P < 0.001, I2 = 88.6%, Ph< 0.001) of GC patients. Furthermore, patients with elevated PLR had a higher risk of lymph node metastasis (OR = 1.17, 95% CI: 1.02–1.33, p = 0.023), serosal invasion (T3 + T4) (OR = 1.34, 95% CI: 1.10–1.64, p = 0.003) and increased advanced stage (III + IV) (OR = 1.20, 95% CI: 1.06–1.37, p = 0.004). Conclusions This meta-analysis demonstrated that elevated PLR was a prognostic factor for poor OS and DFS, and associated with clinicopathological parameters in patients with GC.

scholarly journals A pair-wise meta-analysis highlights circular RNAs as potential biomarkers for colorectal cancer

2019 ◽  
Author(s):  
Chen Li ◽  
Xinli He ◽  
Lele Zhang ◽  
Lanying Li ◽  
Wenzhao Zhao
Keyword(s):  
Colorectal Cancer ◽  
Diagnostic Accuracy ◽  
Cancer Progression ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Circular Rnas ◽  
Depth Of Invasion ◽  
Tumor Diameter

Abstract Background: Circular RNAs (circRNAs) have emerged as a special subset of endogenous RNAs that are implicated in tumorigenesis and cancer progression. Herein we aim to carry out a meta-analysis to evaluate the clinicopathologic, diagnostic and prognostic significance of circRNA expression in colorectal cancer (CRC). Methods: A systematic search of online databases was performed for original articles published in English, which investigated the diagnostic accuracy, prognostic utility, and clinicopathologic association of circRNA(s) in CRC. Data were strictly extracted and study bias was judged using the Quality Assessment for Studies of Diagnostic Accuracy II (QUADAS II) and Newcastle-Ottawa Scale (NOS) checklists. Results: A total of 13 studies, involving 1430 patients with CRC, were included in the meta-analysis. The clinicopathologic study showed that abnormally expressed circRNAs were correlated with tumor diameter (P = 0.0350), differentiation (P = 0.0038), lymphatic metastasis (P = 0.0119), distant metastasis (P < 0.0001), TNM stage (P = 0.0002), and depth of invasion (P=0.001) in patients with CRC. The summary area under the curve (AUC) of circRNA for the discriminative efficacy between patients with and without CRC was estimated to be 0.79, corresponding to a weighted sensitivity of 0.77 [95% confidence interval (CI): 0.74-0.79], specificity of 0.67 (95%CI: 0.64-0.70), and diagnostic odds ratio (DOR) of 7.52 (95%CI: 4.66-12.12). Survival analysis showed that highly expressed circRNAs were correlated with significantly worse overall survival (OS) [hazard ratio (HR) = 2.66, 95%CI: 2.03-3.50, P = 0.000; X2 = 4.34, P = 0.740, I2 = 0.0%], whereas lower expression of circRNAs was associated with prolonged OS (weighted HR=0.30, 95%CI: 0.17-0.53, P = 0.000; X2 = 1.34, P = 0.909, I2 = 0.0%). Stratified analysis in circRNA expression status, and test matrix also showed robust results. Conclusion: Abnormally expressed circRNAs may be auxiliary biomarkers facilitating CRC diagnosis, and promising prognostic biomarkers in predicting the survival of CRC patients.

scholarly journals A pair-wise meta-analysis highlights circular RNAs as potential biomarkers for colorectal cancer

2019 ◽  
Author(s):  
Chen Li ◽  
Xinli He ◽  
Lele Zhang ◽  
Lanying Li ◽  
Wenzhao Zhao
Keyword(s):  
Colorectal Cancer ◽  
Diagnostic Accuracy ◽  
Cancer Progression ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Circular Rnas ◽  
Depth Of Invasion ◽  
Tumor Diameter

Abstract Background: Circular RNAs (circRNAs) have emerged as a special subset of endogenous RNAs that are implicated in tumorigenesis and cancer progression. Herein we aim to carry out a meta-analysis to evaluate the clinicopathologic, diagnostic and prognostic significance of circRNA expression in colorectal cancer (CRC). Methods: A systematic search of online databases was performed for original articles published in English, which investigated the diagnostic accuracy, prognostic utility, and clinicopathologic association of circRNA(s) in CRC. Data were strictly extracted and study bias was judged using the Quality Assessment for Studies of Diagnostic Accuracy II (QUADAS II) and Newcastle-Ottawa Scale (NOS) checklists. Results: A total of 13 studies, involving 1430 patients with CRC, were included in the meta-analysis. The clinicopathologic study showed that abnormally expressed circRNAs were correlated with tumor diameter ( P = 0.0350), differentiation ( P = 0.0038), lymphatic metastasis ( P = 0.0119), distant metastasis ( P < 0.0001), TNM stage ( P = 0.0002), and depth of invasion ( P =0.001) in patients with CRC. The summary area under the curve (AUC) of circRNA for the discriminative efficacy between patients with and without CRC was estimated to be 0.79, corresponding to a weighted sensitivity of 0.77 [95% confidence interval (CI): 0.74-0.79], specificity of 0.67 (95%CI: 0.64-0.70), and diagnostic odds ratio (DOR) of 7.52 (95%CI: 4.66-12.12). Survival analysis showed that highly expressed circRNAs were correlated with significantly worse overall survival (OS) [hazard ratio (HR) = 2.66, 95%CI: 2.03-3.50, P = 0.000; X 2 = 4.34, P = 0.740, I 2 = 0.0%], whereas lower expression of circRNAs was associated with prolonged OS (weighted HR=0.30, 95%CI: 0.17-0.53, P = 0.000; X 2 = 1.34, P = 0.909, I 2 = 0.0%). Stratified analysis in circRNA expression status, and test matrix also showed robust results. Conclusion: Abnormally expressed circRNAs may be auxiliary biomarkers facilitating CRC diagnosis, and promising prognostic biomarkers in predicting the survival of CRC patients.

scholarly journals Systematic Review and Meta-Analysis of the Utility of Circular RNAs as Biomarkers of Hepatocellular Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Qingqin Hao ◽  
Yadi Han ◽  
Wei Xia ◽  
Qinghui Wang ◽  
Huizhong Qian
Keyword(s):  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Clinicopathological Characteristics ◽  
Cochrane Library ◽  
Circular Rnas ◽  
Clinical Value ◽  
Sensitivity Specificity

Emerging studies have reported circRNAs were dysregulated in HCC. However, the clinical value of these circRNAs remains to be clarified. Herein, we aimed to comprehensively explore their association with the diagnosis, prognosis, and clinicopathological characteristics of HCC. PubMed, EMBASE, Web of Science, and Cochrane Library databases were comprehensively searched for eligible studies up to October 30, 2018. The diagnostic effect was evaluated by the pooled sensitivity, specificity, and other indexes. The pooled hazard ratio (HR) for overall survival (OS) and recurrence free survival (RFS) was calculated to assess the prognostic value. Ten studies on diagnosis, 12 on prognosis, and 23 on clinicopathology were identified from the databases. A total of 11 upregulated and 11 downregulated circRNAs showed an association with clinicopathological features of HCC. For the diagnosis analyses, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of circRNAs for HCC were 0.74 (95%CI: 0.65-0.82) and 0.76 (95%CI: 0.70-0.81), 3.1 (95%CI: 2.5-3.8), 0.34 (95%CI: 0.25-0.47), and 9 (95%CI: 6-14), respectively. The area under SROC curve (AUC) was 0.81 (95% CI: 0.78–0.84), indicating moderate diagnostic accuracy. In stratified analyses, the diagnostic performance of circRNAs varied based on the source of control and specimen type. For the prognosis analyses, increased expression of upregulated circRNAs was associated with worse OS (HR: 3.67, 95%: 2.07-6.48), while high expression of downregulated circRNAs was associated with better OS (HR: 0.38, 95%: 0.30-0.48). In conclusion, this study reveals that circRNAs may serve as promising diagnostic and prognostic biomarkers for HCC. However, further investigations are still required to explore the clinical value of circRNAs.

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