The role of circulating microRNAs for the diagnosis of hepatitis B virus-associated hepatocellular carcinoma with low al
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RESEARCH ARTICLE
Open Access
The role of circulating microRNAs for the diagnosis of hepatitis B virus-associated hepatocellular carcinoma with low alphafetoprotein level: a systematic review and meta-analysis Cheng Peng1,2 , Zhuonan Li3, Zishan Xie1,4, Zhanpeng Wang1, Yanshuo Ye1, Bo Li5 and Wei Li1*
Abstract Background: Alpha-fetoprotein (AFP) has been widely used for many years as a serum marker for hepatocellular carcinoma (HCC). However, AFP has been recognized as having poor sensitivity. More and more studies have concluded that circulating microRNAs (miRNAs) might be a promising biomarker that could complement AFP. However, the diagnostic ability of circulating miRNAs has varied among the studies. Therefore, we performed the present meta-analysis to appraise the diagnostic performance of circulating miRNAs as a biomarker for hepatitis B virus-associated HCC (HBV-HCC) patients with low AFP levels. Methods: We performed a systematic review and meta-analysis of the published literature to assess the diagnostic accuracy of circulating miRNAs in differentiating HBV-HCC patients with low AFP levels from non-HCC controls. Results: Circulating miRNAs showed promising potential in the diagnosis of HBV-HCC patients with low AFP levels. In the low-AFP HBV-HCC patients, the area under the curve (AUC) was 0.88 (95% confidence interval [CI]: 0.84–0.90). The pooled sensitivity and specificity were 0.84 (95% CI: 0.78–0.88) and 0.76 (95% CI: 0.69–0.83), respectively. Conclusions: The detection of circulating miRNAs provides a valuable method for the diagnosis of HBV-HCC in patients with low AFP levels. Keywords: miRNAs, HCC, Low AFP, Diagnosis, Meta-analysis
Background Hepatocellular carcinoma (HCC) comprises 75 to 85% of cases of primary liver cancer and ranks as the sixth most commonly diagnosed cancer and the fourth most common cause of cancer-related deaths worldwide [1]. Hepatitis B virus-associated HCC (HBV-HCC) accounts
* Correspondence: [email protected]; [email protected] 1 Department of Hepatobiliary-Pancreatic Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun 130033, China Full list of author information is available at the end of the article
for more than 80% of HCC cases in China and at least 50% of HCC cases worldwide [2]. HCC patients are often diagnosed at the late stage due to lack of specific symptoms, resulting in a relatively low 5-year survival rate of less than 30% worldwide [3], but it can be increased to 60 to 70% for early-stage HCC patients who receive surgical intervention [4]. Therefore, populations at high risk for HCC are recommended to undergo surveillance by abdominal ultrasound (US) plus alpha-fetoprotein (AFP) level screening for HCC, which leads to a better prognosis [5]. However, a large-scale,
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate cr
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