Circulating miRNAs useful for HCC diagnosis
Circulating microRNAs (miRNAs) have acceptable diagnostic accuracy for hepatocellular carcinoma (HCC), reports a recent meta-analysis.
Fifty-nine studies emerged eligible and were eventually included in the meta-analysis. The resulting cumulative sample included 5,125 HCC patients and 6,561 controls. Pooled analysis revealed that the sensitivity and specificity of circulating miRNAs (either individually or in panels) in differentiating HCC from non-HCC cases were 0.81 and 0.76, respectively.
In addition, the positive and negative likelihood ratios and diagnostic odds ratio (DOR) were 3.40, 0.25 and 13.49, respectively. After plotting the summary receiver operating characteristic curve, the resulting area under the curve (AUC) was 0.85.
MiRNA panels, representing a combination of multiple circulating miRNAs, provided better diagnostic accuracy than single miRNAs. The corresponding AUC values obtained were 0.92 and 0.84, while DORs were 34.91 and 11.27, respectively.
Similar findings were reported for the ability of miRNAs to differentiate HCC patients from healthy controls (HC) or from patients with chronic liver disease. MiRNA panels remained superior to single miRNAs in both cases, though the effect was stronger for discriminating HCC from HC.
Including alpha-foetoprotein (AFP) in the diagnostic model appeared to improve the accuracy relative to circulating miRNAs alone. Together, single and panel miRNAs had sensitivity and specificity values for differentiating HCC from non-HCC of 0.85 and 0.88, respectively. The DOR and AUC, in comparison, were 41.17 and 0.93, respectively.
Notably, despite considerable heterogeneity of evidence, findings remained robust to subgroup and meta-regression analyses.