Diagnostic accuracy of cerebrospinal fluid and serum-isolated extracellular vesicles for glioblastoma: a systematic review and meta-analysis

ABSTRACT

Background

Glioblastoma (GBM) is the most malignant brain cancer because there are no available biopsy-free methods for the diagnosis or the preoperative early detection. In this regard, the development of a non- or minimally invasive methods for early detection could increase the survival rate of GBM patients.

Methods

The present study aimed to assess the diagnostic accuracy of extracellular vesicles (EVs) derived RNAs, isolated from patients’ CSF or serum for GBM diagnosis. For this purpose, we searched all literature databases and performed a backward and forward reference checking procedure to retrieve appropriate studies. We conducted a meta-analysis on EVs derived biomarkers as well as sensitivity analysis and meta-regression.

Results

We identified EVs-derived 24 RNAs, which can diagnose GBM. The analyzed pooled data showed 76% sensitivity, 80% specificity, and 0.85 AUC, for 16 biomarkers. Besides, the pooled PLR, NLR, and DOR were 3.7, 0.30, and 12, respectively. Subgroup analysis did not show a significant difference between serum and CSF.

Conclusions

According to the pooled sensitivity, specificity, and AUC for EVs derived biomarkers, we suggest that EVs-derived biomarkers might serve as a high potential and noninvasive diagnostic tool for GBM detection using serum and CSF samples.

KEYWORDS:

• Biomarkers
• exosomes
• extracellular vesicles
• glioblastoma
• meta-analysis

Article highlights

• Extracellular vesicles derived RNA biomarkers could diagnose glioblastoma with 76% sensitivity and 80% specificity.

• The overall AUC for extracellular vesicle-derived biomarkers for the diagnosis of glioblastoma is 0.85.

• There are no significant differences in diagnostic accuracy between serum- and CSF derived EVs for glioblastoma..

Author contributions

D. Jafari was responsible for the conception and design of the study. D.Jafari, A. Tiyuri and E. Rezaei acquired the data. A. Tiyuri, D. Jafari were responsible for analysis and/or interpretation of the data. D. Jafari, A. Tiyuri, R. Jafari, F.J. Shoorijeh and Y. Moradi all drafted the manuscript. D.Jafari, A. Tiyuri, R. Jafari, M. Barati all revised the manuscript in a manner critically for important intellectual content.

Availability of data and material

Input data for the analyses are available from the corresponding author on request.

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.

Reviewer disclosures

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

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This study was funded by the Student Research Committee of Iran University of Medical Sciences [Grant Number: 14892].