SynthesisJournal of the Egyptian National Cancer Institute2026
Circulating microRNAs: a new era in early detection of oral squamous cell carcinoma (OSCC) - a systematic review and meta-analysis.
Synthesis in Journal of the Egyptian National Cancer Institute, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe chances of oral squamous cell carcinoma (OSCC) being diagnosed at an early stage are very low, and this leads to a poor prognosis. The presence of circulating miRNAs (miRNAs) in blood or saliva is now a potential non-invasive diagnostic biomarker, although the diagnostic accuracy of the studies reported remains vastly different due to differences in biofluids, miRNA panels, disease spectrum, and platforms.
methodsWe did a meta-analysis of diagnostic accuracy and a systematic review in accordance with PRISMA-DTA 2020 guidelines (PROSPERO: CRD420251274288). Articles that evaluated circulating miRNAs in any biofluid in diagnosing OSCC were taken into consideration. A Bayesian bivariate random-effects model was used to pool together the sensitivity, specificity, likelihood ratios, diagnostic odds ratios and the summary receiver operating characteristic (sROC) curves. Heterogeneity sources were analyzed using pre-constructed subgroup analysis and meta-regression.
resultsThe number of studies that were evaluated in totality was seventeen and seven were incorporated in the meta-analysis. The pooled sensitivity of the circulating miRNAs towards the detection of OSCC was 0.89 (95% CI: 0.77-0.95) and the pooled specificity was 0.88 (95% CI: 0.75-0.95). It had a pooled positive likelihood ratio (PLR) of 7.25 (95% CI: 3.42-16.08), a negative likelihood ratio (NLR) of 0.13(95% CI: 0.05-0.27), and a diagnostic odds ratio (DOR) of 59.69(95%CI:14.33-209.95). Good performance in discriminating was also noted in the sROC curve with an area under the curve value of approximately 0.90. However, substantial between-study heterogeneity was observed (τ ≈ 0.93 for sensitivity; τ ≈ 0.83 for specificity), and the 95% credible intervals around the DOR were wide (14.33-209.95). Individual studies of multi-miRNA panels reported AUCs up to 0.98, though pooled subgroup estimates were limited by small study numbers and wide uncertainty.
conclusionsCirculating miRNAs and in particular multi-miRNA saliva-based profiles provide promising but heterogenous diagnostic accuracy for OSCC. While individual panel studies have reported high AUCs, the current pooled evidence-derived from only seven small, mostly case-control studies of advanced-stage disease-does not yet establish utility for true early detection or population screening.
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