Objective

Owing to inconsistency between reports, a meta-analysis was designed to appraise the clinical implications of long non-coding RNAs (lncRNAs) in urine and blood for the diagnosis of bladder cancer.

Methods

Studies that met the criteria were acquired by bibliographic retrieval through PubMed, Embase, and the Cochrane Library. The pooled diagnostic performance was evaluated by calculating the area under the summary receiver operator characteristic (SROC) curve. The potential sources of heterogeneity were approached through meta-regression and subgroup analyses. All statistical analyses and plots were performed by RevMan 5.3, Meta-DiSc 1.4, and STATA 12.0.

Results

A total of 43 studies from 15 articles consisting of 3370 bladder cancer patients and 3212 controls were incorporated in our meta-analysis. lncRNAs in urine and blood performed relatively well in diagnosing bladder cancer, with a pooled sensitivity of 0.78, a specificity of 0.79, and an area under the SROC curve (AUC) of 0.86. H19 displayed the best diagnostic accuracy with a pooled AUC of 0.90, followed by UCA1 and MALAT1. The heterogeneity among studies was partly conducted by sample size, lncRNA existence form (cell-free or intracellular lncRNA), lncRNA origin (exosome- or non-exosome-based lncRNA), lncRNA profiling (single- or multiple-lncRNA), specimen types, and ethnicity.

Conclusions

lncRNAs in urine and blood may serve as noninvasive diagnostic biomarkers with great promise for bladder cancer, while their clinical values need to be examined through further synthetic forward-looking studies.

中文翻译：

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循环lncRNA作为膀胱癌的非侵入性生物标记物：基于15篇发表的文章的诊断性荟萃分析。

目的

由于报告之间的不一致，设计了一项荟萃分析，以评估尿液和血液中长链非编码RNA（lncRNA）对诊断膀胱癌的临床意义。

方法

通过PubMed，Embase和Cochrane图书馆的书目检索获得了符合标准的研究。通过计算汇总接收器操作员特征（SROC）曲线下的面积来评估合并的诊断性能。通过荟萃回归和亚组分析来探讨潜在的异质性来源。所有统计分析和绘图均通过RevMan 5.3，Meta-DiSc 1.4和STATA 12.0进行。

结果

我们的荟萃分析纳入了来自15篇文章的43项研究，其中包括3370例膀胱癌患者和3212例对照。尿液和血液中的lncRNA在诊断膀胱癌中表现相对较好，综合敏感性为0.78，特异性为0.79，SROC曲线下面积（AUC）为0.86。H19显示最佳的诊断准确性，合并的AUC为0.90，其次是UCA1和MALAT1。研究之间的异质性部分是由样本量，lncRNA存在形式（无细胞或细胞内lncRNA），lncRNA起源（基于外来体或非外来体的lncRNA），lncRNA分析（单或多IncRNA），样本类型进行的和种族。

结论

尿液和血液中的lncRNA可以作为非侵入性诊断生物标志物，对膀胱癌具有广阔的前景，而其临床价值则需要通过进一步的合成前瞻性研究进行检查。