Comparative assessment of diagnostic value of microRNAs for detection of colorectal cancer in adults: results of systematic review and network meta-analysis

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Abstract

Background. Colorectal cancer remains one of the leading causes of cancer-related mortality worldwide, and early detection is crucial for improving patient outcomes. Circulating microRNAs have emerged as promising non-invasive biomarkers; however, comparative evaluation of their diagnostic performance, particularly in combination panels, remains limited.

Aim. To compare the diagnostic value of circulating microRNAs and their combinations for early colorectal cancer detection in adults using network meta-analysis approach.

Materials and methods. A systematic review and network meta-analysis of studies identified through the PubMed and Embase databases was conducted. The primary outcomes included the area under the ROC curve (AUC), sensitivity, specificity, accuracy, and surface under the cumulative ranking curve (SUCRA). Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Statistical analyses were performed using the R software environment.

Results. The included studies demonstrated substantial methodological and clinical heterogeneity (predominance of case – control design, variability in sample types and cohort characteristics), accompanied by high statistical heterogeneity in the network for AUC (I2 = 74.8 %). According to the network comparison, the most promising single biomarkers were miRNA-760 and miRNA-221, which achieved the highest SUCRA rankings (0.773 and 0.753, respectively). The most extensively studied miRNA-21 showed intermediate performance (SUCRA = 0.677). The highest diagnostic performance was observed for multi-biomarker panels: miRNA-21 + miRNA-25 + miRNA-18a + miRNA-22 (0.888), miRNA-21 + miRNA-92a + miRNA-221 (0.797), and miRNA-21 + miRNA-221 + miRNA-150 (0.797).

Conclusion. Circulating microRNAs represent a promising approach for non-invasive early detection of colorectal cancer. The most relevant candidates include miRNA-760, miRNA-221, and high-performing microRNA panels. Clinical implementation requires further prospective clinical validation and standardization of the analytical methods.

About the authors

E. A. Grivachev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0001-8823-0174
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

A. A. Tryakin

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0003-2245-214X
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

S. V. Vinokurova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0003-1615-3928
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

K. V. Sapozhnikov

S.M. Kirov Military Medical Academy, Ministry of Defense of Russia

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0002-2476-7666
Russian Federation, 6 Akademika Lebedeva St., Saint Petersburg, 194044

E. S. Obarevich

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0001-9885-3922
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

M. D. Fedorova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0002-8813-7516
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

N. A. Sableva

Russian Presidential Academy of National Economy and Public Administration

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0002-5809-9221
Russian Federation, Build. 1, 82 Prospekt Vernadskogo, Moscow, 119571

N. A. Kozlov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0003-3852-3969
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

M. E. Bolotova

Institute of Human Biology and Pathology, N. I. Pirogov Russian National Research Medical University (Pirogov University), Ministry of Health of Russia

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0002-7514-280X
Russian Federation, 8 Leninskiy Prospekt, Moscow, 119049

N. V. Elkina

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0002-0503-6016
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

M. Y. Fedyanin

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: djek-aleksandrov@mail.ru
ORCID iD: 0000-0001-5615-7806
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

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