Upregulated long non-coding RNAs demonstrate promising efficacy for breast cancer detection: a meta-analysis

Purpose: Focusing on the latest literature, dysregulated long non-coding RNAs (lncRNAs) have been extensively explored in breast cancer (BC) research. The purpose of this meta-analysis is to synthesize the evidence on the diagnostic performance of abnormally expressed lncRNAs for BC. Materials and methods: Relevant studies were searched in multiple electronic databases. The Quality Assessment of Diagnosis Accuracy Studies II criteria were applied to assess the quality of included studies. The bivariate meta-analysis model was applied to synthesize the diagnostic parameters using Stata 12.0 software. Publication bias was judged in terms of the Deek's funnel plot asymmetry test. Results: We included 10 eligible studies, which comprised 835 BC patients and 725 paired controls for this meta-analysis. The pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio positive, likelihood ratio negative, and area under the curve (AUC) of upregulated lncRNA expression signature in confirming BC were 0.79 (95% CI: 0.70-0.85), 0.80 (95% CI: 0.73-0.85), 14.61 (95% CI: 10.91-19.55), 3.90 (95% CI: 3.03-5.02), 0.27 (95% CI: 0.20-0.36), and 0.86, respectively. Stratified analyses yielded a sensitivity of 0.83 (95% CI: 0.80-0.86) for serum-based analysis, which was higher than plasma-based analysis, whereas plasma-based analysis revealed a greater specificity of 0.88 (95% CI: 0.85-0.91). Moreover, lncRNA-homeotic genes (HOX) transcript antisense RNA showed a pooled specificity of 0.89 (95% CI: 0.84-0.93) and AUC of 0.86, which were superior to performances by lncRNA-metastasis-associated lung adenocarcinoma transcript-1 and -H19 in diagnosing BC. Notably, the analysis based on cancer subtypes demonstrated that lncRNA expression signature could distinguish triple-negative BC (lacks estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression) from non-triple-negative BC, with an AUC of 0.85. Conclusion: Upregulated lncRNAs reveal an immense potential as novel non-invasive biomarker(s) that could complement BC diagnosis.