A systematic review and meta-analysis of indirect comparison between miRNA and ctDNA in diagnosis of epithelial ovarian cancer.

Background: To evaluate the clinical value of microRNA (miR) and circulating tumor RNA (ctDNA) in the diagnosis of epithelial ovarian cancer (EOC) by meta-analysis and indirect comparison based on common reference criteria.

Methods: The PubMed, EMBASE, MEDLINE, Cochrane Library, Chinese biology medicine (CBM), China national knowledge infrastructure (CNKI), Wanfang, and Chinese Weipu (VIP) databases were searched by computer. The retrieval time limit was from the date of establishment of the database to September 2020. Two researchers independently screened the literature and extracted the basic data according to the inclusion and exclusion criteria formulated in advance, and evaluated the literature quality according to the quality assessment of diagnostic accuracy research (quadas-2). The Meta disc 1.4 and Stata 12.0 software programs were used for meta-analysis to calculate the combined sensitivity, combined specificity, combined positive likelihood ratio, combined negative likelihood ratio and combined diagnostic odds ratio (DOR). The summary receiver operating characteristic (SROC) curve was drawn using Revman 5.3 software, and the stability of the results was evaluated by sensitivity analysis. The publication bias was evaluated by Deek's funnel asymmetric test. The relative diagnostic odds ratio (RDOR) results of indirect comparison between microRNA and ctDNA were obtained using R software.

Results: Nineteen articles were included, including a total of 1,351 EOC patients and 1,194 controls. The heterogeneity test showed that there was obvious heterogeneity caused by non-threshold effect. The random effects model was used for meta-analysis of microRNA in the diagnosis of EOC. The results showed that there was no significant difference between microRNA and ctDNA in the accuracy of EOC diagnosis. The asymmetric test of Deek's funnel chart showed that there was no significant publication bias.

Discussion: There are some limitations in this study, there is no blind diagnostic test, and the intensity of indirect comparison evidence is lower than that of direct comparison evidence. The accuracy of diagnostic tests and the imperfection of mesh meta-analysis statistical methods. MicroRNA and ctDNA have similar clinical diagnostic value for EOC.