QIAN Qian, WANG Ju, YANG Sishuai, LIU Jiwei, PENG Jikui
Objective: To evaluate the diagnostic value of blood-derived exosomes carrying non-coding RNA in colorectal cancer by Meta-analysis, and to provide clinical basis for accurate diagnosis and treatment of colorectal cancer. Methods: Computer-based searches were conducted in databases including PubMed, Embase, and Web of Science to retrieve publicly published literatures on exosomes for colorectal cancer diagnosis from the establishment of each database up to April 10, 2024. Literature screening and data extraction were performed in accordance with the inclusion and exclusion criteria, and the quality of the included literatures was assessed using the QUADAS-2 scale. Software including Stata, Review Manager, and Meta-DiSc was used to analyze the data of the included literatures, and indicators of individual studies were summarized, such as sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), receiver operating characteristic (ROC) curve, and area under the curve (AUC). Subgroup analysis, sensitivity analysis, and the drawing of bivariate box plots were conducted to explore the sources of heterogeneity, and funnel plots were generated to detect publication bias. Results: A total of 12 literatures were included, covering 17 types of exosomal non-coding RNAs. The results of the Meta-analysis showed that the SEN, SPE, PLR, NLR, DOR, and AUC were 0.84 (95%CI: 0.80-0.88), 0.77 (95%CI: 0.71-0.82), 3.64 (95%CI: 2.97-4.45), 0.21 (95%CI:0.17-0.26), 17.60 (95%CI: 13.17-23.52), and 0.88 (95%CI: 0.84-0.90), respectively. After subgroup analysis, it was found that the sensitivity of exosomal LncRNA was 0.92 (95%CI: 0.75-0.98) and its AUC value was 0.92 (95%CI: 0.89-0.94), both of which were higher than those of other subgroups. Conclusion: Exosomes carrying non-coding RNAs have relatively high SEN and SPE, and are expected to become an accurate diagnostic tool for the detection of colorectal cancer.
