The clinical role of microRNA-21 as a promising biomarker in the diagnosis and prognosis of colorectal cancer: a systematic review and meta-analysis

Qiliang Peng _, Xueli Zhang, Ming Min, Li Zou, Peipei Shen and Yaqun Zhu

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Oncotarget. 2017; 8:44893-44909. https://doi.org/10.18632/oncotarget.16488

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Qiliang Peng1,2,3,*, Xueli Zhang4,5,*, Ming Min4, Li Zou1,2,3, Peipei Shen1,2,3 and Yaqun Zhu1,2,3

1 Department of Radiotherapy & Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China

2 Institute of Radiotherapy & Oncology, Soochow University, Suzhou, China

3 Suzhou Key Laboratory for Radiation Oncology, Suzhou, China

4 Center for Systems Biology, Soochow University, Suzhou, China

5 School of Medicine, Örebro University, Örebro, Sweden

* These authors have contributed equally to this work

Correspondence to:

Yaqun Zhu, email:

Keywords: miR-21, diagnosis, prognosis, colorectal cancer, meta-analysis

Received: September 12, 2016 Accepted: March 14, 2017 Published: March 22, 2017


This systematic analysis aimed to investigate the value of microRNA-21 (miR-21) in colorectal cancer for multiple purposes, including diagnosis and prognosis, as well as its predictive power in combination biomarkers. Fifty-seven eligible studies were included in our meta-analysis, including 25 studies for diagnostic meta-analysis and 32 for prognostic meta-analysis. For the diagnostic meta-analysis of miR-21 alone, the overall pooled results for sensitivity, specificity, and area under the curve (AUC) were 0.64 (95% CI: 0.53-0.74), 0.85 (0.79-0.90), and 0.85 (0.81-0.87), respectively. Circulating samples presented corresponding values of 0.72 (0.63-0.79), 0.84 (0.78-0.89), and 0.86 (0.83-0.89), respectively. For the diagnostic meta-analysis of miR-21-related combination biomarkers, the above three parameters were 0.79 (0.69-0.86), 0.79 (0.68-0.87), and 0.86 (0.83-0.89), respectively. Notably, subgroup analysis suggested that miRNA combination markers in circulation exhibited high predictive power, with sensitivity of 0.85 (0.70-0.93), specificity of 0.86 (0.77-0.92), and AUC of 0.92 (0.89-0.94). For the prognostic meta-analysis, patients with higher expression of miR-21 had significant shorter disease-free survival [DFS; pooled hazard ratio (HR): 1.60; 95% CI: 1.20-2.15] and overall survival (OS; 1.54; 1.27-1.86). The combined HR in tissues for DFS and OS were 1.76 (1.31-2.36) and 1.58 (1.30-1.93), respectively. Our comprehensive systematic review revealed that circulating miR-21 may be suitable as a diagnostic biomarker, while tissue miR-21 could be a prognostic marker for colorectal cancer. In addition, miRNA combination biomarkers may provide a new approach for clinical application.

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