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MicroRNA Technology Shows Promise in Cervical Cancer Diagnosis

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The landscape of cervical cancer diagnosis may be on the brink of transformation with the advent of microRNA technology. This innovative approach has been systematically reviewed to assess its diagnostic accuracy, revealing promising results for both Cervical Intraepithelial Neoplasia (CIN) and cervical cancer detection. The study embarked on a comprehensive search of online databases and grey literature, focusing on articles published between January 1, 2012, and August 16, 2022.

Researchers meticulously followed the PRISMA-P guidelines and employed the QUADAS-2 tool to evaluate the risk of bias across the studies included. Out of 297 articles, data from 24 studies were eventually extracted for the review. This analysis highlights the higher diagnostic accuracy of specific microRNAs, notably miR-205, miR-21, miR-192, and miR-9, with Area Under the Curve (AUC) values indicating their robust potential in distinguishing CIN from healthy controls.

MicroRNA Panels and Diagnostic Accuracy

The study also delved into the efficacy of microRNA panels. Combinations such as miR-21, miR-125b, and miR-370, as well as miR-9, miR-10a, miR-20a, miR-196a, and miR-16-2, demonstrated substantial diagnostic accuracy for CIN, with AUC values of 0.897 and 0.886, respectively. These findings underscore the potential of microRNA panels as reliable diagnostic tools.

For cervical cancer detection, the same microRNAs (miR-21, miR-205, miR-192, and miR-9) exhibited significant diagnostic accuracy, with AUC values of 0.723, 0.960, 1.00, and 0.99, respectively. This suggests their applicability as standalone screening or diagnostic tests, either individually or combined with other biomarkers.

Market Access and Future Directions

From a market access perspective, the high diagnostic accuracy of these microRNAs could pave the way for more accessible and efficient screening methods globally. Particularly in high-prevalence regions such as sub-Saharan Africa and South Asia, standardized quantification methods and further studies could enhance the implementation of these technologies.

Future research should focus on standardizing quantification methods and exploring the diagnostic value of microRNAs in diverse populations. This could significantly impact the early detection and treatment of cervical cancer, potentially improving patient outcomes and reducing healthcare costs.

Key Takeaways for Market Access

  • MicroRNA technology may offer a cost-effective, high-accuracy alternative for cervical cancer screening.
  • Standardization in quantification methods is essential for widespread adoption.
  • High-prevalence regions could benefit significantly from microRNA-based diagnostics.
  • Combining microRNAs with other biomarkers may enhance diagnostic reliability.
  • Future research should prioritize diverse and high-prevalence populations for broader applicability.

The review protocol for this study was registered with PROSPERO (CRD42022313275), ensuring adherence to rigorous research standards. The collective findings highlight the transformative potential of microRNA technology in cervical cancer diagnostics, setting the stage for future innovations in the field.

Original Article:

Gynecol Oncol Rep. 2024 Jun 4;54:101424. doi: 10.1016/j.gore.2024.101424. eCollection 2024 Aug.

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ABSTRACT

Studies suggest a need for new diagnostic approaches for cervical cancer including microRNA technology. In this review, we assessed the diagnostic accuracy of microRNAs in detecting cervical cancer and Cervical Intraepithelial Neoplasia (CIN). We performed a systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline for protocols (PRISMA-P). We searched for all articles in online databases and grey literature from 01st January 2012 to 16th August 2022. We used the quality assessment of diagnostic accuracy studies tool (QUADAS-2) to assess the risk of bias of included studies and then conducted a Random Effects Meta-analysis. We identified 297 articles and eventually extracted data from 24 studies. Serum/plasma concentration miR-205, miR-21, miR-192, and miR-9 showed highest diagnostic accuracy (AUC of 0.750, 0.689, 0.980, and 0.900, respectively) for detecting CIN from healthy controls. MicroRNA panels (miR-21, miR-125b and miR-370) and (miR-9, miR-10a, miR-20a and miR-196a and miR-16-2) had AUC values of 0.897 and 0.886 respectively for detecting CIN from healthy controls. For detection of cervical cancer from healthy controls, the most promising microRNAs were miR-21, miR-205, miR-192 and miR-9 (AUC values of 0.723, 0.960, 1.00, and 0.99 respectively). We report higher diagnostic accuracy of upregulated microRNAs, especially miR-205, miR-9, miR-192, and miR-21. This highlights their potential as stand-alone screening or diagnostic tests, either with others, in a new algorithm, or together with other biomarkers for purposes of detecting cervical lesions. Future studies could standardize quantification methods, and also study microRNAs in higher prevalence populations like in sub-Saharan Africa and South Asia. Our review protocol was registered in PROSPERO (CRD42022313275).

PMID:38939506 | PMC:PMC11208915 | DOI:10.1016/j.gore.2024.101424

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