Diagnostic value of microRNAs for malignant pleural mesothelioma: A mini-review

Our plain-English summary of Diagnostic value of microRNAs for malignant pleural mesothelioma: A mini-review, by Y.Q. Han, S.C. Xu, W.Q. Zheng, et al (Thoracic Cancer, 2021).

The study

• Authors: Y.Q. Han, S.C. Xu, W.Q. Zheng, Z.D. Hu
• Journal: Thoracic Cancer
• Published: 2021;12(1):8-12
• Type of article: Review
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant pleural mesothelioma (MPM) is a type of cancer originating from the pleura with high aggressiveness and poor prognosis. A timely diagnosis is crucial to improve its prognosis. Laboratory biomarkers have significant advantages of reduced invasiveness, low cost, and are observer-independent, and therefore represent a promising diagnostic tool for MPM. MicroRNA is a family of non-coding RNA that regulates gene expression at the post-transcriptional level. Accumulated studies showed that microRNA, either in tissue, circulating, and body fluid, has potential diagnostic value for various disorders. Here, we reviewed the diagnostic value of microRNA for MPM.

© 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

In plain English

This mini-review summarized published research on whether microRNAs, small molecules that regulate genes, could help diagnose malignant pleural mesothelioma (MPM). It reported no new data and did not say how many studies it covered or how they were chosen. The authors reported that microRNAs measured in tumor tissue generally showed unsatisfactory accuracy, with areas under the curve (AUC, an accuracy score) below 0.80, although one study's combined model reached 0.96. Only one study had examined pleural fluid. In that study, a combination of three microRNAs reached an AUC of 0.94. In blood, several single microRNAs gave moderate results. One reviewed study of 60 MPM patients and 20 workers formerly exposed to asbestos reported AUCs of 0.92 and 0.98 for miR-548a-3p and miR-20a. Results for miR-126 varied between studies. The authors concluded that many microRNAs can assist in MPM diagnosis and that most have moderate accuracy, but that microRNA panels are a promising tool. They noted that all available studies were small, lacked clear and uniform enrollment criteria, and may suffer from patient selection bias.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: mini-review (narrative review of published studies; no search method or study count given)
• Who was studied: Published studies of microRNAs in tumor tissue, pleural effusion (fluid around the lung) and blood of people with malignant pleural mesothelioma, compared with various control groups. The review does not state how many studies were included.
• Exposure: Not an exposure study. Some reviewed studies used people with past asbestos exposure as comparison groups. In one study, 76% of the 60 MPM patients had a history of asbestos exposure and the comparison group was 20 workers formerly exposed to asbestos. No fiber types are named.
• Main results:
  • Tissue microRNAs: diagnostic accuracy was generally unsatisfactory (AUCs below 0.80). One reviewed study's mathematical model combining microRNAs reached AUC = 0.96.
  • Pleural effusion microRNAs: only one study (Birnie et al., 2019). The four microRNAs validated by PCR each had AUCs below 0.80, but a model combining miR-200c, miR-143 and miR-210 had an AUC of 0.94.
  • Circulating microRNAs: miR-197-3p, miR-625-3p and miR-132 showed moderate accuracy, with AUCs of 0.76, 0.82 and 0.75.
  • In a reviewed study of 60 MPM patients (76% with a history of asbestos exposure) compared with 20 workers formerly exposed to asbestos, miR-548a-3p and miR-20a had AUCs of 0.92 and 0.98.
  • Circulating miR-126 gave varied results: AUC 0.75 against non-small cell lung cancer controls, and 0.95 in one study and 0.71 in another against healthy controls. In a head-to-head comparison it was lower than SMRP (0.71 vs. 0.72), but combining the two improved accuracy.
  • Exosomal microRNAs: in the one study comparing MPM patients with people with a history of asbestos exposure, miR-103, miR-98, miR-148b, miR-744 and miR-30e-3p had AUCs larger than 0.83.
  • Blood cell miR-103: AUC of 0.76 in a small study, lower than SMRP in a larger study. A model combining miR-103 and SMRP had an AUC of 0.90.
• The authors' conclusion: The authors concluded that many microRNAs can assist in MPM diagnosis and that most candidates have moderate diagnostic accuracy, but that microRNA panels are a promising diagnostic tool. They called for further studies to identify more candidates and validate existing findings.
• Limitations the authors state:
  • The sample sizes of all available studies were small.
  • The studies used no clear and uniform enrollment criteria and did not report whether subjects were enrolled consecutively, so patient selection bias cannot be excluded.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Pleura, Prognosis, Biomarker.

Related studies

• Diagnostic value of microRNAs in asbestos exposure and malignant mesothelioma: systematic review and qualitative meta-analysis — L. Micolucci, M.M. Akhtar, et al. (2016)
• MicroRNAs diagnostic and prognostic value as predictive markers for malignant mesothelioma — E. Sturchio, M.G. Berardinelli, et al. (2020)
• Progress of research on microRNAs with diagnostic value in asbestos exposure: A call for method standardization — L. Micolucci, M.R. Rippo, et al. (2017)
• MicroRNA signature of malignant mesothelioma with potential diagnostic and prognostic implications — S. Busacca, S. Germano, et al. (2010)
• A diagnostic assay based on microRNA expression accurately identifies malignant pleural mesothelioma — H. Benjamin, D. Lebanony, et al. (2010)
• MicroRNA profiling in serous cavity specimens: Diagnostic challenges and new opportunities — L. Nicolè, F. Cappello, et al. (2019)

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