Influence of dysregulated expression of circular RNA on the diagnosis and prognosis of breast cancer in Asia: a meta-analysis study

OBJECTIVE: Recent studies have reported a correlation between non-coding RNAs such as circular RNAs (circRNAs) and clinical value of various cancers. However, the diagnostic and prognostic role of circRNA in breast cancer remains controversial. DESIGN: Systematic review and meta-analysis. METHODS: Diagnostic efficacy was estimated by sensitivity, specificity and area under the curve (AUC). Pooled HRs with 95% CIs estimated overall survival (OS), and ORs with 95% CIs investigated clinical features. RESULTS: By searching PubMed, Embase, Web of Science, CNKI and Cochrane Library, we obtained a total of 29 studies with 4405 patients. A shorter survival time was associated with high expression levels of tumour-promoter circRNAs (OS: HR=2.43, 95% CI 2.20 to 2.92, p<0.001), and tumour‐suppressor circRNAs were related to a favourable prognosis (OS: HR=0.32, 95% CI 0.23 to 0.44, p<0.001). Furthermore, high expression levels of oncogenic circRNAs were associated with poor clinical outcomes; tumour-suppressor circRNAs showed the opposite result. As for the diagnostic role, the outcome indicated an AUC of 0.82 (95% CI 0.78 to 0.85), with 85% sensitivity and 86% specificity to distinguish patients with breast cancer from healthy controls. CONCLUSION: Dysregulated expression of circRNA was related to diagnosis and prognosis in breast cancer, which indicated it might be a novel biomarker and a target of therapy for breast cancer. PROSPERO REGISTRATION NUMBER: CRD42020207912.