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Diagnostic value of circular RNAs as effective biomarkers for cancer: a systematic review and meta-analysis

Authors Tan H, Gan L, Fan X, Liu L, Liu S

Received 8 December 2018

Accepted for publication 27 February 2019

Published 10 April 2019 Volume 2019:12 Pages 2623—2633


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Sanjeev Srivastava

Hong Tan,1,* Li Gan,2,* Xiaoming Fan,3 Limin Liu,4 Shan Liu3

1Department of General Surgery, Chengdu Integrated TCM & Western Medicine Hospital (Chengdu First People’s Hospital), Chengdu, 610041, China; 2School of Medicine, University of Electronic Science and Technology of China, Key Laboratory for Human Disease Gene Study, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, 610054, China; 3Department of Laboratory Medicine, Affiliated Hospital of University of Electronic Science and Technology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, 610072, China; 4Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochou University, Institute of Blood and Marrow Transplantation, Suzhou, 215006, China 
*These authors contributed equally to this work

Background: Increasing evidence has identified circular RNAs (circRNAs) as ideal molecular biomarkers for cancer diagnosis, therapy, and prognosis. However, the overall diagnostic efficiency of circRNAs remains unclear. Thus, this meta-analysis aimed to comprehensively evaluate the diagnostic accuracy of circRNA expression profiles for cancer.
Methods: A literature search of online databases was conducted to identify all eligible studies. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. All statistical analyses were executed using STATA 14.0, Meta-DiSc 1.4, and Review Manager 5.2 software.
Results: A total of 32 studies, involving 2,400 cases and 2,295 controls, were included in the diagnostic meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve were 0.79 (95% CI: 0.73–0.84), 0.73 (95% CI: 0.67–0.79), 2.9 (95% CI: 2.5–3.5), 0.29 (95% CI: 0.24–0.36), 10 (95% CI: 8–13), and 0.83 (95% CI: 0.79–0.86), respectively. The overall analysis suggested that circRNAs are useful diagnostic biomarkers for cancer. Subgroup analysis indicated that plasma samples had a better diagnostic performance than cancer tissue samples for cancer detection. Studies involving ≥100 cases or gastric cancer showed higher sensitivities than those including <100 cases or other cancers. 
Conclusion: This meta-analysis revealed that circRNAs were significantly correlated with cancer diagnosis. In addition, circRNAs had good diagnostic accuracy and might serve as effective diagnostic biomarkers for cancer.

Keywords: circular RNAs, cancer, diagnosis, biomarkers, meta-analysis

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