The diagnostic accuracy of liquid exosomes for lung cancer detection: a meta-analysis

PURPOSE: Several studies have suggested that liquid exosomes can be used as biomarkers for the diagnosis of lung cancer (LC). The purpose of this meta-analysis was to investigate the comprehensive diagnostic value of liquid exosomes for LC. MATERIALS AND METHODS: Relevant studies were searched from multiple electronic databases. The quality of the studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies-2 criteria in RevMan 5.3 software. Stata 14.0 software and Meta-disc 1.4 software were used to synthesize the diagnostic parameters. Publication bias was judged according to the Deeks’ funnel plot asymmetry test. RESULTS: There were 13 eligible articles that comprised 1,338 LC patients and 1,075 paired controls for the meta-analysis. The pooled sensitivity (SEN), specificity (SPE), diagnostic likelihood ratio positive (DLR+), diagnostic likelihood ratio negative (DLR−), diagnostic OR (DOR), and area under the curve (AUC) of liquid exosomes in diagnosing LC were 0.82 (95% CI: 0.76–0.87), 0.84 (95% CI: 0.77–0.89), 5.27 (95% CI: 3.58–7.75), 0.21 (95% CI: 0.15–0.29), 25.14 (95% CI: 14.25–44.33), and 0.90 (95% CI: 0.87–0.92), respectively. Research based on serum, miRNA, the isolation kit method, one index in exosomes, patient sample size of 50 or greater, and control group size of 50 or greater obtained higher AUC values when the LC type was small cell lung cancer. CONCLUSION: Liquid exosomes have shown potential as novel biomarkers that could facilitate LC diagnosis. Further prospective studies are still needed to confirm the diagnostic value of liquid exosomes.