1. Department of Emergency and Trauma Center, The International Medical Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China.
2. Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China.
Background: Traumatic brain injury (TBI) is a sudden trauma on the head, in which severe TBI (sTBI) is usually associated with death and long-term disability. MicroRNAs (miRNAs) are potential biomarkers of diverse diseases, including TBI. However, few systematic reviews and meta-analyses have been conducted to determine the clinical value of miRNAs expression in TBI patients.
Methods: We conducted this systematic review and meta-analysis study according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, the Cochrane Library, Web of Science, from inception to August 26, 2020. We included articles written in English that have reported on the diagnostic value of miRNAs expression in TBI patients. We excluded studies that did not provided sufficient information to construct the 2×2 contingency table.
Results: Eight studies investigating the diagnostic value of miRNA in TBI were analyzed in this study. The overall sensitivity, specificity and area under the curve (AUC) of miRNAs in diagnosis of TBI were 89% [95% confidence interval (CI): 0.84-0.93], 92% (95% CI 0.82-0.97) and 95% (95% CI 0.93-0.97). We found that panels of multiple miRNAs could improve the diagnostic accuracy of TBI. Samples from blood and brain tissue have significantly enhanced diagnostic accuracy, when compared with saliva. The AUC of miRNAs in severe TBI was 0.97, with 91% sensitivity and 92% specificity.
Conclusion: This systematic review and meta-analysis demonstrated that miRNAs could be potential diagnostic markers in TBI patients. MiRNAs detected in blood and brain tissue display high accuracy for TBI diagnosis.
Keywords: miRNAs, TBI, diagnosis, biomarker, meta-analysis