Abstract
Osteosarcoma (OS) is one of the most common primary malignant tumors in adolescents. In recent years, multiple studies have reported the value of miRNAs in the diagnosis of OS, but the results were very different from each other. Therefore, we conducted this meta-analysis to determine the accuracy of miRNAs in the diagnosis of OS. The meta-analysis searched for relevant researches including PubMed, EMBASE, Web of Science, Wanfang database and China National Knowledge Infrastructure (CNKI) as of June 1, 2020. We used the quality assessment of Diagnostic Accuracy Study 2 (QUADAS-2) to score the quality of each study. A random effects model was used to pool the sensitivity and specificity. We measured the diagnostic value using positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the curve (AUC). Subgroup and meta-regression analysis were used to find potential sources of heterogeneity. The meta-analysis finally included 31 articles about 2634 OS patients and 1715 healthy controls. The pooled estimations showed that the circulating miRNAs has a high accuracy in diagnosing OS, with a sensitivity of 0.79, specificity of 0.89, PLR of 7.3, NLR of 0.23, DOR of 31, and AUC of 0.90. In addition, subgroup and meta-regression analysis showed that miRNA clusters have higher diagnostic accuracy than single miRNA, and miRNAs in plasma were more reliable than those in serum. In conclusion, peripheral blood miRNA is a potential noninvasive biomarker to assist in the early diagnosis of OS, especially young patients with bone pain and/or indeterminate radiology findings.