Identification of microRNAs as biomarkers for cholangiocarcinoma detection: A diagnostic meta-analysis

Background: Cholangiocarcinoma (CCA) is a common biliary malignancy that results in high mortality and poor survival rates. The diagnostic capacity of miRNAs in CCA detection is still controversial. Current meta-analysis evaluate the evidence on the capacity of miRNAs for CCA diagnosis. Methods: A systematic literature search for relevant articles in PubMed, Embase and Web of science database up to 10 April 2016 was conducted. The pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR) and area under the curve (AUC) were pooled to assess the overall diagnostic value of miRNA. Subgroup analysis was further applied to explore the between-study heterogeneity. Publication bias was assessed with Deeks' funnel plot. Statistical analysis was carried out using RevMan 5.2 and MetaDisc 1.4. Results: A total of 501 patients and 248 controls from 14 studies in 8 articles were included in this meta-analysis. The pooled sensitivity and specialty were 0.83 (0.80-0.86) and 0.79 (0.75-0.83), respectively. The pooled PLR was 3.96 (2.64-5.94), NLR was 0.25 (0.19-0.34), DOR was 18.1 (9.79-33.5) and pooled AUC was 0.88 (0.85-0.90). Subgroup analyses indicated that the serum miRNA assays showed highly accurate CCA diagnosis. The diagnostic capacity was more accurate in Caucasians than in Asians. Conclusions: The miRNA assays are promising diagnostic tools for CCA detection with moderate accuracy. However, further prospective studies were needed to confirm this results before clinical application. (C) 2016 Elsevier Masson SAS. All rights reserved.