胰腺导管腺癌的外泌体RNA生物标志物:系统回顾和荟萃分析。

IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY
Clinica Chimica Acta Pub Date : 2026-01-01 Epub Date: 2025-08-06 DOI:10.1016/j.cca.2025.120532
Amir Tiyuri, Haniyeh Hatami, Zahra Mobarezi, Mina Zareardalan, Ghazal Salari, Aida Zandi Abbas Abadi, Marziyeh Mirzazad, Anahita Ebrahimi Mojaveri, Davod Jafari
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引用次数: 0

摘要

胰腺癌是一种高度致命的恶性肿瘤,在所有癌症的发病率中排名第十,是全球癌症相关死亡的第四大原因。本系统综述和荟萃分析评估了外泌体生物标志物检测胰腺导管腺癌(PDAC)的诊断性能。通过在Scopus、Web of Science和PubMed中进行综合检索,共确定了1666条记录。在删除重复和筛选标题、摘要和全文后,纳入了15项研究,包括1961名个体(971名PDAC患者和990名对照)。使用QUADAS-2工具评估研究质量,揭示主要在患者选择和指数测试领域的潜在偏差。分析了三种生物标志物类别:外泌体microRNAs (exomiRs)、癌抗原19-9 (CA 19-9)和glypican-1 (GPC1)。ExomiRs的总灵敏度最高(0.86;95 % CI: 0.80-0.90)和最低负似然比(0.16;95 % CI: 0.11-0.24),而CA 19-9的特异性最高(0.91;95 % CI: 0.84-0.95)和正似然比(8.5;95 % ci: 4.4-16.4)。ExomiRs的诊断优势比也最高(DOR = 35.4;95 % CI: 18.7-67.0)和SROC曲线下面积(AUC = 0.92;95 % CI: 0.89-0.94),与CA 19-9和GPC1 (AUC分别= 0.88和0.78)相比,显示出更好的诊断性能。GPC1在所有分析中始终显示较低的诊断指标。Deeks漏斗图显示CA 19-9和GPC1没有发表偏倚,但显示exomir有潜在偏倚(P = 0.01)。总的来说,在PDAC的早期检测中,外泌体似乎是有希望的非侵入性生物标志物,在诊断准确性方面优于传统的和其他基于外泌体的标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exosomal RNA biomarkers in pancreatic ductal adenocarcinoma: Systematic review and meta-analysis.

Pancreatic cancer is a highly lethal malignancy, ranking tenth in incidence among all cancers and standing as the fourth leading cause of cancer-related mortality worldwide. This systematic review and meta-analysis evaluated the diagnostic performance of exosomal biomarkers for detecting pancreatic ductal adenocarcinoma (PDAC). A total of 1,666 records were identified through comprehensive searches in Scopus, Web of Science, and PubMed. After removing duplicates and screening titles, abstracts, and full texts, 15 studies comprising 1,961 individuals (971 PDAC patients and 990 controls) were included. The quality of studies was assessed using the QUADAS-2 tool, revealing potential biases mainly in patient selection and index test domains. Three biomarker categories were analyzed: exosomal microRNAs (exomiRs), cancer antigen 19-9 (CA 19-9), and glypican-1 (GPC1). ExomiRs demonstrated the highest pooled sensitivity (0.86; 95 % CI: 0.80-0.90) and lowest negative likelihood ratio (0.16; 95 % CI: 0.11-0.24), while CA 19-9 showed the highest specificity (0.91; 95 % CI: 0.84-0.95) and positive likelihood ratio (8.5; 95 % CI: 4.4-16.4). ExomiRs also had the highest diagnostic odds ratio (DOR = 35.4; 95 % CI: 18.7-67.0) and area under the SROC curve (AUC = 0.92; 95 % CI: 0.89-0.94), indicating superior diagnostic performance compared to CA 19-9 and GPC1 (AUC = 0.88 and 0.78, respectively). GPC1 consistently showed lower diagnostic metrics across all analyses. Deeks' funnel plot suggested no publication bias for CA 19-9 and GPC1, but indicated potential bias for exomiRs (P = 0.01). Overall, exomiRs appear to be promising non-invasive biomarkers for the early detection of PDAC, outperforming traditional and other exosome-based markers in diagnostic accuracy.

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来源期刊
Clinica Chimica Acta
Clinica Chimica Acta 医学-医学实验技术
CiteScore
10.10
自引率
2.00%
发文量
1268
审稿时长
23 days
期刊介绍: The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells. The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.
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