Chunyue Long, Hongjin Shi, Jinyu Li, Lijian Chen, Mei Lv, Wenlin Tai, Haifeng Wang, Yiheng Xu
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All statistical analyses and plots were conducted with STATA 14.0 and RevMan5.3.</p><p><strong>Results: </strong>A total of 678 articles were retrieved by means of the search strategy of the online database. Through screening, 21 articles were obtained, involving 3348 participants and 77 studies. The meta-analysis of the results indicated that urinary exosomes had a combined sensitivity of 0.75, a specificity of 0.77, and a combined AUC of 0.83 for the diagnosis of BC, suggesting that urine-derived exosomes have a relatively satisfactory diagnostic effect in the detection of BC. Among the subgroups classified by biomarker, long non-coding RNAs (lncRNAs) had the highest comprehensive sensitivity (SEN = 0.78), and miRNAs had the highest comprehensive specificity (SPN = 0.81). 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引用次数: 0
摘要
导言：尿液中的外泌体有可能成为诊断膀胱癌（BC）的生物标记物。本研究旨在通过对不同研究进行荟萃分析，系统评估尿源性外泌体在膀胱癌患者中的诊断价值：方法：我们在PubMed、Web of Science、Embase、Cochrane和CNKI数据库中进行了系统检索，以获取通过尿源性外泌体诊断BC的相关文献。我们设计了一种文献检索策略，从文献中挑选文章并提取所需的数据。采用QUADS-2评估所收录文献的质量，并通过计算综合SROC曲线下的面积来评估综合诊断效果。所有统计分析和绘图均使用 STATA 14.0 和 RevMan5.3 进行：通过在线数据库的检索策略，共检索到 678 篇文章。通过筛选，共获得 21 篇文章，涉及 3348 名参与者和 77 项研究。荟萃分析结果表明，尿液外泌体诊断BC的综合灵敏度为0.75，特异度为0.77，综合AUC为0.83，表明尿液外泌体在检测BC方面具有较为理想的诊断效果。在按生物标志物分类的亚组中，长非编码RNA（lncRNA）的综合灵敏度最高（SEN = 0.78），miRNA的综合特异性最高（SPN = 0.81）。在其他亚组分析中，多种外泌体联合诊断的生物标记物面板显示出最佳诊断效果，曲线下综合面积（AUC）为0.87：作为一种新型生物标志物，尿源性外泌体在诊断乳腺癌方面具有重要的诊断前景。尽管如此，将其应用于临床仍需要大量的临床试验来证实其临床可行性和实用性。
The diagnostic accuracy of urine-derived exosomes for bladder cancer: a systematic review and meta-analysis.
Introduction: Urine-derived exosomes could potentially be biomarkers for bladder cancer (BC) diagnosis. This study aimed to systematically evaluate the diagnostic worth of urine-derived exosomes in BC patients through a meta-analysis of diverse studies.
Methods: A systematic search was carried out in PubMed, Web of Science, Embase, Cochrane, and CNKI databases to obtain the literature concerning the diagnosis of BC via urine-derived exosomes. A literature retrieval strategy was devised to pick articles and extract needed data from the literature. QUADS-2 was used to evaluate the quality of the included literatures, and the aggregated diagnostic effect was assessed by calculating the area under the aggregated SROC curve. All statistical analyses and plots were conducted with STATA 14.0 and RevMan5.3.
Results: A total of 678 articles were retrieved by means of the search strategy of the online database. Through screening, 21 articles were obtained, involving 3348 participants and 77 studies. The meta-analysis of the results indicated that urinary exosomes had a combined sensitivity of 0.75, a specificity of 0.77, and a combined AUC of 0.83 for the diagnosis of BC, suggesting that urine-derived exosomes have a relatively satisfactory diagnostic effect in the detection of BC. Among the subgroups classified by biomarker, long non-coding RNAs (lncRNAs) had the highest comprehensive sensitivity (SEN = 0.78), and miRNAs had the highest comprehensive specificity (SPN = 0.81). In other subgroup analyses, the biomarker panel for multiple exosomes combined diagnosis demonstrated the best diagnostic efficacy, with a combined the area under the curve ( AUC) of 0.87.
Conclusions: As a novel biomarker, urine-derived exosomes have significant diagnostic prospects in the diagnosis of BC. Nevertheless, their application in clinical settings still demands a considerable number of clinical trials to confirm their clinical feasibility and practicability.
期刊介绍：
World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics.
Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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