The diagnostic role of microRNA-34a in breast cancer: a systematic review and meta-analysis
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Saber Imani1,2, Xianqin Zhang1, Hossein Hosseinifard3, Shangyi Fu4, Junjiang Fu1
1Key Laboratory of Epigenetics and Oncology, The Research Center for Precision Medicine, Southwest Medical University, Luzhou, Sichuan, PR China
2Chemical Injuries Research Center, Baqiyatallah Medical Sciences University (BMSU), Tehran, Iran
3Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran
4Honors College, University of Houston, Houston, TX, USA
Keywords: breast cancer, microRNA-34a, biomarker, diagnostics, meta-analysis
Received: November 18, 2016 Accepted: January 30, 2017 Published: February 20, 2017
Background: MicroRNA-34a (miR-34a) is a master regulator of tumor suppression in breast cancer (BC). This systematic review aims to analyze the diagnostic accuracy of miR-34a in the detection of BC as a biomarker.
Results: A total of 1858 BC cases and 494 controls from thirteen eligible studies reported in 9 publications were included. The overall pooled sensitivity, specificity, negative likelihood ratio (NLR), positive likelihood ratio (PLR), and diagnostic odds ratio (DOR) were 85.50% (95% CI: 83.80-87.00%), 70.00% (95% CI: 65.80–74.10%), 0.29 (95% CI: 0.19–0.43), 2.58 (95% CI: 1.91–3.43), and 9.39 (95% CI: 5.47–16.12), respectively. Similarly, the overall area under the curve (AUC) of the summary receiver operating characteristic (SROC) was 0.80, indicating the high conservation of miR-34a as a biomarker. Furthermore, subgroup analysis suggested that the use of miR-34a as a biomarker is more accurate in tissue-based sample of invasive BC. We also indicated that miR-34a is a capable biomarker in diagnosing BC in people of Caucasian descent.
Materials and Methods: A systematic search was conducted for eligible publications that address miR-34a expression level in BC cases and noncancerous controls. Diagnostic capacity of miR-34a for BC was assessed using pooled sensitivity and specificity, DOR, and AUC of SROC. PLR and NLR were verified to estimate the miR-34a diagnostic accuracy in clinical level. The quality of the included studies was assessed by QUADAS-2.
Conclusions: These findings suggest miR-34a is a promising non-invasive biomarker in diagnosing BC. Well-designed cohort studies should be implemented to warrant the diagnostic value of miR-34a in clinical purposes.
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