Clinical significance of microRNA expressions in diagnosing uterine cancer and predicting lymph node metastasis.

Recently, accumulating lines of evidence have demonstrated the association between microRNA (miRNAs) expression and uterine cancer, indicating that they may serve as promising novel biomarkers for uterine cancer. Therefore, we conducted this study to systematically evaluate the diagnostic accuracy of miRNAs in discriminating the uterine cancer patients from controls and further to determine their diagnostic values in lymph node metastasis (LNM) prediction. The pooled sensitivity, specificity, and other parameters, together with summary receiver operating characteristic (SROC) curve were used to assess the overall test performance. All statistical analyses were conducted using STATA 12.0 software. A total of nine articles were included in this meta-analysis. As for the accuracy of miRNAs in differentiating uterine cancer from controls, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under curve (AUC) were 0.84, 0.83, 4.8, 0.19, 25, and 0.90, respectively. As for the diagnostic accuracy of miRNAs in differentiating patients with LNM from those without LNM, the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.75, 0.78, 3.5, 0.32, 011, and 0.83, respectively. In addition, subgroup analyses based on miRNA profiles suggested that multiple-miRNA assay displayed much better accuracy than single-miRNA assay, with an excellent AUC of 0.98 (92% sensitivity and 96% specificity). The high accuracy of multiple-miRNA assay, together with the application of miRNAs in LNM prediction, suggested that miRNAs may serve as non-invasive diagnostic markers of uterine cancer and further improve the comprehensive management of patients with uterine cancer. However, further larger studies are needed to confirm our findings.