Potential role of circulating miR-21 in the diagnosis of hepatocellular carcinoma: a systematic review and meta-analysis

ABSTRACT

Objective

Identify original articles that analyzed the diagnostic value of miR-21 in hepatocellular carcinoma without language restriction or publication date.

Methodology

We performed structured searches on PubMed, Web of Science, VHL, and EMBASE. The Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields was used to assess the quality of each study. Random effect models were used to study heterogeneity, evaluated based on the Higgins I2 statistic.

Results

12 articles were evaluated and contained raw data from 1,329 individuals, of which 617 had HCC, 473 were healthy, and 239 had Chronic liver disease. The combined sensitivity and combined specificity of miR-21 for diagnosing HCC were, respectively, 0.83(95% CI:0.78-0.89) and 0.85(95% CI:0.80-0.90). The sensitivity and specificity, in that order, by type of control were 0.81 (95% CI: 0.71-0.91) and 0.88 (95% CI: 0.82-0.93) for CLDs and 0.86(95% CI: 0.81-0.91) and 0.83(95% CI:0.74-0.91) for Healthy controls.

Conclusion

miR-21 has a moderate overall performance in diagnosing HCC and may serve as a potential non-invasive marker for this early-stage disease. Thus, it may contribute to complementing the results of alpha-fetoprotein in the diagnosis and help to detect HCC at an earlier stage, increasing the survival chances of these patients.

KEYWORDS:

• biomarker
• microRNAs
• early diagnosis
• hepatocellular carcinoma
• diagnosis
• meta-analysis

Acknowledgments

We would like to thank all the authors of the studies included in this meta-analysis.

Article highlights

• miR-21 has a moderate overall performance for use in the diagnosis of HCC;

• miR-21 has the potential to serve as an early-stage non-invasive marker;

• Moderate overall diagnostic power was demonstrated with a more remarkable ability to distinguish this miRNA in Healthy controls than in Chronic liver diseases (CLDs) and African subjects than in Asians.

• miR-21 may complement the results of alpha-fetoprotein (AFP) in the diagnosis and thus help to detect hepatocellular carcinoma (HCC) at an earlier stage, increasing the chances of survival of these patients.;

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Availability of data and material

The data supporting this article’s conclusions are included in the article and the additional files submitted to the journal.

Author contributions

AKSF: this author helped in developing the idea, writing the protocol, designing the study, searching the databases, screening, data extraction, writing, and reviewing the manuscript and approving the final version.

TFMB: this author helped in writing the protocol, screening, data extraction, writing, and reviewing the manuscript and approving the final version.

KPO: this author helped in writing the protocol, screening, data extraction, writing, and reviewing the manuscript and approving the final version.

ASS: this author helped in writing the protocol, screening, data extraction, writing, and reviewing the manuscript and approving the final version.

ICCF: this author helped in writing the protocol, screening, data extraction, writing, and reviewing the manuscript and approving the final version.

EJPS: this author helped in developing the idea, writing the protocol, designing the study, searching the databases, screening, data extraction, writing, and reviewing the manuscript and approving the final version.

LRSV: this author helped in writing the protocol, screening, data extraction, writing, and reviewing the manuscript and approving the final version.

Additional information

Funding

This paper was not funded.