Exploring the Diagnostic Test Accuracy of MicroRNAs as Potential Biomarkers for Glioblastoma: Systematic Review and Meta-Analysis.

Abstract

Glioblastoma (GBM) is the most common and devastating primary malignant brain tumor. Early diagnosis and treatment are essential for improving patient outcomes, and microRNA (miRNA)-based liquid biopsies offer a promising, minimally invasive diagnostic approach. The aim of this systematic review was to evaluate the diagnostic accuracy of miRNA-based liquid biopsies for GBM. A comprehensive systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using Ovid Medline and Embase. Studies were selected up to October 16, 2024, based on predefined inclusion criteria. Data were extracted to construct 2 × 2 contingency tables, and diagnostic performance was evaluated using pooled and individual sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio metrics. From 1829 identified studies, 15 articles met inclusion criteria, comprising 28 miRNA evaluations with 868 samples from 551 GBM patients and 811 samples from 578 controls. The pooled sensitivity and specificity for miRNA-based diagnostic biomarkers for GBM were 0.84 (95% credible interval [CI]: 0.78-0.89) and 0.89 (95% CI: 0.84-0.92), respectively. Heterogeneity across the data set was 66% for sensitivity and 39% for specificity. Negative likelihood ratios for both noncancer (0.20, 95% CI: 0.15-0.27) and non-GBM brain tumor (0.24, 95% CI: 0.14-0.35) controls were low. miRNAs, especially miR-21, demonstrate significant utility for diagnosis of GBM and for ruling out diagnosis in patients who do not have GBM. These findings support the further development of miRNA-based liquid biopsies for GBM diagnosis with emphasis on clinical validation and standardization of technique.