Diagnostic and prognostic role of circRNAs in pancreatic cancer: a meta-analysis

Ruihua Zhao; Zhuo Han; Haiting Zhou; Yaru Xue; Xiaobing Chen; Xinguang Cao

doi:10.3389/fonc.2023.1174577

Diagnostic and prognostic role of circRNAs in pancreatic cancer: a meta-analysis

Front Oncol. 2023 Jun 8:13:1174577. doi: 10.3389/fonc.2023.1174577. eCollection 2023.

Authors

Ruihua Zhao¹, Zhuo Han², Haiting Zhou³, Yaru Xue⁴, Xiaobing Chen⁵, Xinguang Cao⁶

Affiliations

¹ Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
² Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an, China.
³ Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
⁴ Department of Pediatric Medicine, Northwest Women's and Children's Hospital, Xi'an, China.
⁵ Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
⁶ Department of Digestive Disease, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Abstract

Background: Circular RNAs (circRNAs) are types of endogenous noncoding RNAs produced by selective splicing that are expressed highly specifically in various organisms and tissues and have numerous clinical implications in the regulation of cancer development and progression. Since circRNA is resistant to digestion by ribonucleases and has a long half-life, there is increasing evidence that circRNA can be used as an ideal candidate biomarker for the early diagnosis and prognosis of tumors. In this study, we aimed to reveal the diagnostic and prognostic value of circRNA in human pancreatic cancer (PC).

Methods: A systematic search for publications from inception to 22 July 2022 was conducted on Embase, PubMed, Web of Science (WOS), and the Cochrane Library databases. Available studies that correlated circRNA expression in tissue or serum with the clinicopathological, diagnostic, and prognostic values of PC patients were enrolled. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to evaluate clinical pathological characteristics. Area under the curve (AUC), sensitivity, and specificity were adopted to assess diagnostic value. Hazard ratios (HRs) were utilized to assess disease-free survival (DFS) and overall survival (OS).

Results: This meta-analysis enrolled 32 eligible studies, including six on diagnosis and 21 on prognosis, which accounted for 2,396 cases from 245 references. For clinical parameters, high expression of carcinogenic circRNA was significantly associated with degree of differentiation (OR = 1.85, 95% CI = 1.47-2.34), TNM stage (OR = 0.46, 95% CI = 0.35-0.62), lymph node metastasis (OR = 0.39, 95% CI = 0.32-0.48), and distant metastasis (OR = 0.26, 95% CI = 0.13-0.51). As for clinical diagnostic utility, circRNA could discriminate patients with pancreatic cancer from controls, with an AUC of 0.86 (95% CI: 0.82-0.88), a relatively high sensitivity of 84%, and a specificity of 80% in tissue. In terms of prognostic significance, carcinogenic circRNA was correlated with poor OS (HR = 2.00, 95% CI: 1.76-2.26) and DFS (HR = 1.96, 95% CI: 1.47-2.62).

Conclusion: In summary, this study demonstrated that circRNA may act as a significant diagnostic and prognostic biomarker for pancreatic cancer.

Keywords: circular RNAs; diagnostic; meta-analysis; pancreatic cancer; prognostic.

Publication types

Systematic Review