Diagnostic accuracy of circulating long noncoding RNAs in hepatocellular carcinoma: a systematic review and meta-analysis
Abstract
Background: Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, largely due to late diagnosis and the limited sensitivity of current screening biomarkers such as alpha-fetoprotein (AFP). Circulating long noncoding RNAs (lncRNAs) have recently emerged as promising, noninvasive biomarkers that may reflect the molecular mechanisms underlying hepatocarcinogenesis. This systematic review and meta-analysis aimed to comprehensively evaluate the diagnostic accuracy of circulating lncRNAs for detecting HCC.
Methods: A systematic search of PubMed, Scopus, Web of Science, and Embase was performed up to March 2025 following the PRISMA-DTA guidelines. Eligible studies reporting the diagnostic performance of circulating lncRNAs for HCC were included. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated using a bivariate random-effects model. Subgroup analyses were conducted according to sample type, detection method, and reference standard.
Results: Eighty-one studies encompassing over 6,000 participants were included. The pooled sensitivity and specificity of circulating lncRNAs were 0.83 (95% CI: 0.80-0.86) and 0.80 (95% CI: 0.75-0.84), respectively, with an area under the summary receiver operating characteristic (SROC) curve of 0.88. Serum-based assays showed slightly higher accuracy than plasma-based assays. lncRNAs also demonstrated good diagnostic performance in discriminating HCC from cirrhotic patients, as well…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 6,000 participants or records.
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