The expression of circRNAs as a promising biomarker in the diagnosis and prognosis of human cancers: a systematic review and meta-analysis

Han-Xi Ding, Zhi Lv, Yuan Yuan and Qian Xu _

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Oncotarget. 2018; 9:11824-11836. https://doi.org/10.18632/oncotarget.23484

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Han-Xi Ding1, Zhi Lv1, Yuan Yuan1,2 and Qian Xu1,2

1Tumor Etiology and Screening Department of Cancer Institute and General Surgery, The First Affiliated Hospital of China Medical University, Key Laboratory of Cancer Etiology and Prevention, China Medical University, Liaoning Provincial Education Department, Shenyang 110001, China

2National Clinical Research Center for Digestive Diseases, Xi’an 110001, China

Correspondence to:

Qian Xu, email: [email protected]

Yuan Yuan, email: [email protected]

Keywords: diagnosis, prognosis, cancers, circRNAs, biomarker

Received: August 02, 2017     Accepted: October 05, 2017     Published: December 15, 2017


Background: CircRNAs, a type of non-coding RNAs with special loop structure, of which the aberrant expression is closely related to tumor growth, proliferation, metastasis and recurrence. It remains unclear whether they have the potential to be biomarkers for diagnosis and prognosis of cancers. The study aims to clarify the relationship of circRNAs expression with cancers diagnosis and prognosis.

Materials and Methods: Sensitivity, specificity, area under curve (AUC) and receiver operating characteristic curve (ROC) were calculated to evaluate the diagnostic efficacy; Hazard ratio (HR) of overall survival (OS), disease free survival (DFS) and recurrence free survival (RFS) were calculated to evaluate the association between circRNAs expression and survival of cancer patients.

Results: A total of 27 studies were involved in the meta-analysis, including 16 diagnostic and 11 prognostic articles. Among the diagnostic studies, 18 kinds of circRNAs had been investigated, in which 3 were up regulated and 15 were down regulated. Their pooled sensitivity, specificity and AUC were 0.71(0.65–0.77), 0.77(0.72–0.81) and 0.81(0.77–0.84), respectively. In stratified analysis, a higher specificity was shown in circRNAs for diagnosing gastric cancer and hepatocellular cancer. 12 circRNAs were involved in the prognostic studies, including 6 up-regulated and 6 down-regulated circRNAs. Their overall HR of OS and DFS/RFS were 1.37(0.98–1.75) and 2.28 (0.77–3.79), respectively.

Conclusions: CircRNAs have the potential to be biomarkers for diagnosis and prognosis of cancers. Further investigations are still needed to explore the clinical value of circRNAs as tumor markers.

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