MicroRNA-371-3 cluster as biomarkers for the diagnosis and prognosis of cancers

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  Objective MicroRNA-371-3(miR-371-3)cluster locates on chromosome 19 and has three members,miR-371,MiR-372 and miR-373.Up regulated miR-371-3p have been reported to reverse the acquired drug resistance and improve overall survival of cancer patients.MiR-372 and miR-373,which were reported to have capacity to active wild-type p53,counteract p53-mediated CDK inhibition and nourish oncogenic RAS to promote testicular germ cell cancerous process.For miR-372,by directly targeting the 3-UTR,overexpression miR-372 repressed insulin-like growth factor 2mRNA-binding protein 1(IGF2BP1)to suppress cancer proliferation and metastasis.For miR-373,it has been identified to be significantly elevated in lymph node-positive breast tumor samples,indicating that it plays role in invasion and metastasis of tumors.However,there are some reports hold different attitudes that down regulation of miR-373 in nonsmall-cell-lung-cancer(NSCLC)cells was observed to be associated with suppression of the cell EMT,proliferation,migration and invasion.Therefore,the role of miR-371-3 in development and progression of cancers remains obscure.In addition,the cluster was also reported as diagnostic or prognostic biomarker,but the conclusions have been remaining elusive.MiR-371 and miR-372 in serum was reported to have a diagnostic value for germ cell tumors,testicular germ cell cancer,gastric cancer,pancreatic cancer,and breast cancer,respectively.However,for miR-371,the sensitivity and specify were ranged from 75%to 98.60%,and 63.41%to 99.00%with AUC from 0.715 to 0.929,respectively and for miR-372,the sensitivity and specify were ranged from 68.00%to 96.80%,and 84.3%to 100%with AUC from 0.84 to 0.879,respectively.Such a various result was aroused from the different sample size,cut-off value,or cancer types.On the other hand,studies have evaluated the prognostic value of miR-372 and miR-373 for cancers,and reported they could serve as favorable survival indicators,as well as adverse survival indicators.Therefore,the diagnostic and prognostic values of miR-371-3 cluster were unclear currently.Hence,considering the disputable evaluation of the miR-371-3 cluster,this study were performed to integrate related published studies to evaluate the potential role of these miRNAs as diagnostic and prognostic biomarkers in various cancers.Methods We searched from electronic databases(PubMed,EMBASE and Web of Science databases)(Jan 1,2007 to Jun 1,2018).The pooled sensitivity,specificity and area under the curve(AUC)of summary receiver operator characteristic(SROC)curve for diagnostic value meanwhile the pooled hazard ration(HR)and 95%CI were used to explore prognosis capacity of miR-372 and miR-373.In addition,publication bias of enrolled studies was tested and sensitivity analysis of each study was performed to evaluate the stability of the pooled results.Results A total of 11 eligible studies containing 6 eligible studies containing 870 participants for diagnosis and 1218 cancer cases for prognosis were selected for this study.For diagnosis,the pooled results revealed that the miR-371(sensitivity: 0.85,specificity: 0.92,AUC: 0.92)and miR-373(sensitivity: 0.81,specificity: 0.93,AUC: 0.93)could be used as diagnostic biomarkers.For prognosis,we observed that elevated miR-372 was associated poor prognosis(high expression vs.low expression: HR=2.31,95%CI: 1.04-5.14,PHeterogeneity<0.001,I2=87.9%),especially in cutoff value subgroup of median(HR=2.62,95%CI: 1.54-4.46,PHeterogeneity=0.139,I2=45.3%).The pooled results of subgroup with qRT-RCR method showed that high expression of miR-372 indicated poor prognosis after one study with ISH excepted(HR=2.94,95%CI: 1.82-4.74,PHeterogeneity=0.101,I2=48.4%).In addition,pooled results shown that expression of miR-373 was not related with prognosis because of the significant heterogeneity,and the high miR-373 expression presented favorable prognosis in Asian(HR=0.34,95%CI: 0.23-0.50)after omitting the study of heterogeneity origin.Finally,publication bias and sensitivity analyses were performed.For miR-373,results of pooled HR was stable; however,for miR-372,the HR was changed from 2.31(95%CI: 1.04-5.14)to 2.94(95%CI: 1.82-4.74)when one of studies discarded.Eggers and Beggs tests were utilized to evaluate publication bias of studies and the symmetric funnel plots indicated that there were no significant publication biases for the miR-373(t=0.28,p=0.792),but for miR-372,publication biases were existent(t=3.33,p=0.029).Conclusions The current studies demonstrated that the miR-371 and miR-373 could be a predictive tumor diagnostic biomarker and the expression of miR-372 and miR-373 may indicate prognosis of cancer patients.
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