Identification of circulating MicroRNAs as novel potential biomarkers for hepatocellular carcinoma detection: a systematic review and meta-analysis.

MicroRNAs (miRNAs) in body fluids such as serum and plasma can be stably detected and used as potential biomarkers in hepatocellular carcinoma (HCC) diagnosis. To systematically evaluate circulating miRNAs from HCC expression profiling studies and to determine miRNA biomarkers for HCC detection. A systematic review and meta-analysis of published studies were carried out for comparing the circulating miRNA expressions between HCC patients and healthy people, hepatitis, or cirrhosis patients. A miRNA ranking system that considered the number of comparisons in agreement and total number of samples was used. Then the summary receiver-operating characteristic curve (sROC) results of the top miRNAs were combined to further evaluate their diagnostic value using Meta-disc 1.4. In the 17 included studies, three circulating miRNAs (miR-21, miR-122, and miR-223) were repeatedly reported three times or more in both HCC patients vs. healthy controls and vs. other hepatitis or cirrhosis patients. In further analysis, the area under curve (AUC) of sROC for miR-21, miR-122 and miR-223 in discriminating HCC patients from healthy people are 0.9293, 0.8128, and 0.8597, respectively. Circulating miR-21 has highest level of diagnostic efficiency among three miRNAs candidate biomarkers (miR-21, miR-122, and miR-223) for detection of HCC.