scholarly journals Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

2021 ◽  
Author(s):  
Jing Huang ◽  
Yuan Lu ◽  
Xihua Wang ◽  
Xiaoli Zhu ◽  
Ping Li ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Transbronchial Needle Aspiration ◽  
Sensitivity Specificity ◽  
Malignant Lymph Nodes

Abstract Background: Endobronchial ultrasound (EBUS) elastography has been applied in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on the tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely used for onsite evaluation of the adequacy of the samples and guiding the sampling during EBUS-TBNA. The aim of the study is to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating of mediastinal and hilar lymph nodes status.Methods: A retrospective chart review was performed from December 2018 to September 2020. Patients’ demographic, EBUS elastography score, ROSE, pathologic and clinical outcomes were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly non-blue; Type 2, partially blue and partially non-blue; Type 3, predominantly blue. Receiver operating characteristic (ROC) curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio among EBUS elastography, ROSE, and EBUS combined with ROSE groups for evaluation of malignant lymph nodes.Results: A total of 247 patients (345 lymph nodes) were included in our study. The sensitivity and specificity of EBUS elastography group in the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE alone group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE group were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under curve was 0.942.Conclusions: The combination of EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph nodes status.

scholarly journals Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Huang ◽  
Yuan Lu ◽  
Xihua Wang ◽  
Xiaoli Zhu ◽  
Ping Li ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Endobronchial Ultrasound ◽  
Lymph Node Status ◽  
Transbronchial Needle Aspiration ◽  
Hilar Lymph Node ◽  
Malignant Lymph Nodes

Abstract Background Endobronchial ultrasound (EBUS) elastography has been used in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely utilized for onsite evaluation of sample adequacy and for guiding sampling during EBUS-TBNA. The aim of this study was to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating mediastinal and hilar lymph node status. Methods Retrospective chart review was performed from December 2018 to September 2020. Patient demographics, EBUS elastography scores, and ROSE, pathologic, and clinical outcome data were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly nonblue; Type 2, partially blue and partially nonblue; and Type 3, predominantly blue. A receiver operating characteristic curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for evaluation of malignant lymph nodes among the EBUS elastography, ROSE, and EBUS combined with ROSE groups. Results A total of 245 patients (345 lymph nodes) were included. The sensitivity and specificity of the EBUS elastography group for the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under the curve was 0.942. Conclusions Combining EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph node status compared to each method alone.

scholarly journals Diagnostic value of endobronchial ultrasound elastography for differentiating benign and malignant hilar and mediastinal lymph nodes: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jiangfeng Wu ◽  
Yue Sun ◽  
Yunlai Wang ◽  
Lijing Ge ◽  
Yun Jin ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymph Nodes ◽  
Sensitivity Specificity

Aims: In the present study, a meta-analysis was performed to evaluate the diagnostic value of endobronchial ultrasound (EBUS) elastography for differentiating benign and malignant hilar and mediastinal lymph nodes (LNs). Material and methods: A comprehensive literature search was carried out through PubMed, Embase, and Cochrane Library. Two authors screened the papers and extracted the data independently and any discrepancies were resolved by discussion. The methodolog-ical quality of each included study was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the curve were calculated to evaluate the value of EBUS elastography for hilar and mediastinal LNs. Results: Seventeen studies with the number of 2307 LNs were included. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of hilar and mediastinal LNs by EBUS elastography were 0.90 (95% confidence interval [CI], 0.84-0.94), 0.78 (95% CI, 0.74-0.81), 4.1 (95% CI, 3.4-4.9), 0.12 (95% CI, 0.07-0.21) and 33 (95% CI, 17-64), respectively. Furthermore, area under the curve was calculated to be 0.86 (95% CI, 0.82-0.88). Conclusion: EBUS elastography is a valuable technology in the differentiation of benign and malignant hilar and mediastinal LNs and could provide supplementary diagnostic information during endobronchial ultrasound-guided transbronchial needle aspiration. The combination of EBUS elastography and B-mode EBUS could improve the diagnostic accuracy for hilar and mediastinal LNs.

scholarly journals Factors Affecting the Accuracy of Endoscopic Ultrasonography in the Diagnosis of Early Gastric Cancer Invasion Depth: A Meta-analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Ding Shi ◽  
Xiao-xia Xi
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Likelihood Ratio ◽  
Endoscopic Ultrasonography ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Depth Of Invasion ◽  
Invasion Depth ◽  
Sensitivity Specificity

Background. Endoscopic ultrasonography (EUS) is the first imaging modality for investigating the depth of invasion in early gastric cancer (EGC). However, there is presently no consensus on the accuracy of EUS in diagnosing the invasion depth of EGC. Aim. This study is aimed at systematically evaluating the accuracy of EUS in diagnosing the invasion depth of EGC and its affecting factors. Methods. The literatures were identified by searching PubMed, SpringerLink, Cochrane Library, Web of Science, Nature, and Karger knowledge databases. Two researchers extracted the data from the literature and reconstructed these in 2×2 tables. The Meta-DiSc software was used to evaluate the overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic advantage ratio, and 95% confidence interval (CI). The SROC was drawn, and the area under the curve (AUC) was calculated to evaluate the diagnostic value. Results. A total of 17 articles were selected, which included 4525 cases of lesions. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic dominance ratio, and 95% CI of EUS for diagnosing EGC was 0.87 (95% CI: 0.86-0.88), 0.67 (95% CI: 0.65-0.70), 2.90 (95% CI: 2.25-3.75), 0.17 (95% CI: 0.13-0.23), and 18.25 (95% CI: 12.61-26.39), respectively. The overall overstaging rate of mucosa/submucosa 1 (M/SM1) and SM by EUS was 13.31% and 32.8%, respectively, while the overall understaging rate of SM was 29.7%. The total misdiagnosis rates for EUS were as follows: 30.4% for lesions≥2 cm and 20.9% for lesions<2 cm, 27.7% for ulcerative lesions and 21.4% for nonulcerative lesions, and 22% for differentiated lesions and 26.9% for undifferentiated lesions. Conclusion. EUS has a moderate diagnostic value for the depth of invasion of EGC. The shape, size, and differentiation of lesions might be the main factors that affect the accuracy of EUS in diagnosing EGC.

scholarly journals Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: A meta-analysis

2020 ◽  
Author(s):  
Ke Wang ◽  
Shan Cong ◽  
Tiangang Ma ◽  
Xin Di ◽  
Chang Tian ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Interleukin 6 ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Summary Receiver Operating Characteristic ◽  
Neutrophil Cd64 ◽  
Sensitivity Specificity

Abstract The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) for the diagnosis of sepsis. The sample articles were searched in various databases to collect published studies on the diagnosis of sepsis by neutrophil CD64, PCT, and IL-6. By using the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated. 54 articles were included in the study. The number of studies that evaluated the diagnostic value of neutrophil CD64, PCT, and interleukin-6 were 20, 39, and 15, respectively. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 [95% confidence interval (CI), 0.81–0.92], 0.88 (95% CI, 0.83–0.91), and 0.94 (95% CI, 0.91–0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78–0.85), 0.78 (95% CI, 0.74–0.82), and 0.87 (95% CI, 0.83–0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83–0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78–0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65–0.78), 0.70 (95% CI, 0.62–0.76), and 0.77 (95% CI, 0.73–0.80), respectively. Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic value for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.

scholarly journals Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shan Cong ◽  
Tiangang Ma ◽  
Xin Di ◽  
Chang Tian ◽  
Min Zhao ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Interleukin 6 ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Adult Patients ◽  
Neutrophil Cd64 ◽  
Diagnostic Potential ◽  
Sensitivity Specificity

Abstract Background The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) as markers for the diagnosis of sepsis in adult patients. Methods Various databases were searched to collect published studies on the diagnosis of sepsis in adult patients using neutrophil CD64, PCT, and IL-6 levels. Utilizing the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated. Results Fifty-four articles were included in the study. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 (95% confidence interval [CI], 0.81–0.92), 0.88 (95% CI, 0.83–0.91), and 0.94 (95% CI, 0.91–0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78–0.85), 0.78 (95% CI, 0.74–0.82), and 0.87 (95% CI, 0.83–0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83–0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78–0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65–0.78), 0.70 (95% CI, 0.62–0.76), and 0.77 (95% CI, 0.73–0.80), respectively. Conclusions Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic potential for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.

scholarly journals Hepatic Subcapsular Flow as a Significant Diagnostic Marker for Biliary Atresia: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Chao Sun ◽  
Bin Wu ◽  
Jiang Pan ◽  
Lulu Chen ◽  
Wenxian Zhi ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Sensitivity Specificity ◽  
Larger Sample

Aim. Increasing evidence indicates that hepatic subcapsular flow (HSF) can serve as a noninvasive ultrasonographic marker for the early diagnosis of biliary atresia (BA). However, results regarding its diagnostic accuracy are inconsistent and inconclusive. We conducted this meta-analysis with an aim to systematically evaluate the diagnostic value of HSF in predicting BA. Methods. A comprehensive literature search of four databases was conducted to identify the eligible studies. All analyses were performed using STATA 12.0. Results. Nine studies from eight articles containing 368 patients and 469 controls were included in our meta-analysis. Briefly, the values for pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were 0.95 (95% CI 0.88-0.98), 0.92 (95% CI 0.85-0.96), 11.6 (95% CI 6.3-21.5), 0.06 (95% CI 0.02-0.14), 201 (95% CI 59-689), and 0.98 (95% CI 0.96-0.99), respectively. Additionally, metaregression along with subgroup analysis based on various covariates revealed the potential sources of heterogeneity and the detailed diagnostic value in each subgroup. Conclusion. Our meta-analysis showed that HSF assay could provide high accuracy in predicting BA patients and non-BA individuals. However, further studies with better design and larger sample size are required to support the results of the present study.

scholarly journals The Accuracy of Ultrasound-guided Fine-needle Aspiration and Core Needle Biopsy in Diagnosing Axillary Lymph Nodes in Women With Breast Cancer: a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Haining Zheng ◽  
Rui Zhao ◽  
Wei Wang ◽  
Xiaona Liu ◽  
Xiaoqing Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Likelihood Ratio ◽  
Needle Biopsy ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Ultrasound Guided

Abstract Background: This study performed an overall assessment of the accuracy of ultrasound-guided fine-needle aspiration (FNA) and core needle biopsy (CNB) for detecting axillary lymph nodes in women with breast cancer based on qualified studies.Methods: Eligible studies and pertinent literature resources were identified on Cochrane, PubMed, Embase, CNKI, VIP, and Wanfang databases through searching key words or terms. The latest study was published in the March 2020. The eligible publications contained cohort and cross-sectional researches. All the publications obtained were tested for heterogeneity, and corresponding effect models were used to calculate amalgamative values of sensitivity, specificity and diagnostic odds ratio (DOR). Analysis of summary receiver operating characteristic (SROC) was performed on suspicious axillary lymph nodes.Results: A total of 22 studies involving 3548 patients were included to explore the accuracy of FNA in identifying axillary lymph nodes in women with breast cancer. 11 studies involving 758 patients were included to explore the accuracy of CNB in identifying axillary lymph nodes in women with breast cancer. The accuracy of FNA in identifying suspicious axillary lymph nodes was specifically as follows: overall sensitivity was 79% (95%CI: 73%-84%), global specificity was 96% (95%CI: 92%-98%), overall positive likelihood ratio was 18.55 (95% CI: 10.53-32.69), overall negative likelihood ratio was 0.22 (95% CI: 0.17-0.28), the overall DOR was 71.68 (95%CI: 37.19-138.12), and the acreage under the SROC was (AUC = 0.94; 95% CI: 0.92-0.96). The accuracy of CNB in identifying suspicious axillary lymph nodes was specifically as follows: overall sensitivity was 85% (95%CI: 81%-89%), global specificity was 93% (95%CI: 87%-96%), overall positive likelihood ratio was 11.88 (95% CI: 6.56-21.50), overall negative likelihood ratio was 0.16 (95% CI: 0.12-0.21), the overall DOR was 66.83 (95%CI: 33.28-134.21), and the acreage under the SROC was (AUC = 0.96; 95% CI: 0.94-0.97).Conclusions: The results indicated that both FNA and CNB had high accuracy for suspicious axillary lymph nodes.

scholarly journals Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases

2015 ◽  
Vol 41 (5) ◽  
pp. 410-414 ◽  
Author(s):  
Mediha Gonenc Ortakoylu ◽  
Sinem Iliaz ◽  
Ayse Bahadir ◽  
Asuman Aslan ◽  
Raim Iliaz ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Lung Disease ◽  
Diagnostic Value ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Pulmonary Medicine ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Male Patients ◽  
Granulomatous Diseases

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis) the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56%) were male and 70 (44%) were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84%) were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy.

Endobronchial Ultrasound Elastography Combined With Computed Tomography in Differentiating Benign from Malignant Intrathoracic Lymph Nodes

2020 ◽  
pp. 155335062097802
Author(s):  
Surong Fang ◽  
Ligong Chang ◽  
Feifei Chen ◽  
Xiaoming Mao ◽  
Wei Gu
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Area Ratio ◽  
Ultrasound Elastography ◽  
Endobronchial Ultrasound ◽  
Transbronchial Needle Aspiration ◽  
Sensitivity Specificity ◽  
Short Diameter

Objective. This study was to combine endobronchial ultrasound elastography (UE) with computed tomography (CT) to identify benign and malignant thoracic lymph nodes (LNs) more objectively and accurately. Methods. A total of 42 patients with intrathoracic lymphadenopathy required for endobronchial ultrasound with real-time guided transbronchial needle aspiration (EBUS-TBNA) examination were enrolled. All patients were examined by enhanced chest CT, B-mode ultrasound, and endobronchial ultrasound (EBUS)-guided elastography before EBUS-TBNA. Each lymph node was assessed by describing the characteristics of CT image (short diameter, texture, shape, boundary, and mean CT value), B-mode ultrasound (short diameter, echo characteristic, shape, and boundary), and elastography (image type, grading score, strain rate, and blue area ratio). The pathological results were used as the gold standard. The characteristics were compared alone and in combination between benign and malignant LNs. Results. The blue area ratio of elastography combined with CT had better diagnostic value in differentiating benign and malignant LNs than elastography alone, with the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) being 92%, 96%, 80%, 94%, and 86% vs 81%, 77%, 93%, 97%, and 56%, respectively. Elastography combined with B-mode ultrasound and CT characteristics showed the highest diagnostic value. Accuracy, sensitivity, specificity, PPV, and NPV were all 100%. Conclusions. Endobronchial UE combined with CT and B-mode ultrasound imaging shows a greater diagnostic value in differentiating benign and malignant intrathoracic LNs than either imaging alone.

scholarly journals The Potential Diagnostic Accuracy of Circulating MicroRNAs for Leukemia: A Meta-Analysis

2021 ◽  
Vol 20 ◽  
pp. 153303382110119
Author(s):  
Wen-Ting Zhang ◽  
Guo-Xun Zhang ◽  
Shuai-Shuai Gao
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Circulating Micrornas ◽  
Sensitivity Specificity

Background: Leukemia is a common malignant disease in the human blood system. Many researchers have proposed circulating microRNAs as biomarkers for the diagnosis of leukemia. We conducted a meta-analysis to evaluate the diagnostic accuracy of circulating miRNAs in the diagnosis of leukemia. Methods: A comprehensive literature search (updated to October 13, 2020) in PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure (CNKI) was performed to identify eligible studies. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) for diagnosing leukemia were pooled for both overall and subgroup analysis. The meta-regression and subgroup analysis were performed to explore heterogeneity and Deeks’ funnel plot was used to assess publication bias. Results: 49 studies from 22 publications with a total of 3,489 leukemia patients and 2,756 healthy controls were included in this meta-analysis. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve were 0.83, 0.92, 10.8, 0.18, 59 and 0.94, respectively. Subgroup analysis shows that the microRNA clusters of plasma type could carry out a better diagnostic accuracy of leukemia patients. In addition, publication bias was not found. Conclusions: Circulating microRNAs can be used as a promising noninvasive biomarker in the early diagnosis of leukemia.

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