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Diagnostic efficacy of serum microRNAs in predicting pathology of retroperitoneal lymph node dissection in patients with testicular germ cell tumors: a systematic review and meta-analysis

M. Kardoust Parizi, N. Singla, S. Daneshmand, A. Heidenreich, A. Bagrodia, V. Margulis, A. Matsukawa, I. Tsuboi, SF. Shariat

. 2025 ; 43 (1) : 192. [pub] 20250327

Language English Country Germany

Document type Journal Article, Systematic Review, Meta-Analysis, Review

Persistent link   https://www.medvik.cz/link/bmc25009429

PURPOSE: To evaluate the diagnostic efficacy of serum microRNAs in predicting pathologic findings of retroperitoneal lymph node dissection (RPLND) in patients with testicular germ cell tumors (TGCT). METHODS: PUBMED, SCOPUS, and Cochrane Library were searched in August 2024 to identify eligible studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. RESULTS: Nine studies comprising 603 patients were selected in this review. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of microRNA-371a-3p for predicting viable tumor other than pure teratoma in RPLND specimen were 0.76 (95% CI 0.49-0.90), 0.97 (95% CI 0.81-0.99) and 31.75 (95% CI 9.24-109.10), respectively. The pooled sensitivity for primary and post-chemotherapy RPLND (PC-RPLND), were 0.77 (95% CI 0.47-0.93) and 0.73 (95% CI 0.28-0.95), respectively. The pooled specificity for primary and PC-RPLND were 0.92 (95% CI 0.72-0.98) and 0.99 (95% CI 0.62-1.00), respectively. The pooled DOR for primary and PC-RPLND were 13.86 (95% CI 2.97-64.79) and 64.11 (95% CI 13.09-313.98), respectively. The major limitation is the lack of standardization of miR371 testing. CONCLUSION: miR-371a-3p is a relatively sensitive and highly specific marker for predicting viable tumors in RPLND pathologic findings. The DOR was particularly significant for patients who underwent PC-RPLND. While serum microRNAs may be useful in distinguishing viable germ cell tumors from necrosis, fibrosis, and teratomas, their ability to differentiate teratomas from necrosis is limited. Well-designed prospective studies are essential to enhance our understanding of the predictive performance of microRNAs.

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$a Kardoust Parizi, Mehdi $u Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria $u Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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$a Diagnostic efficacy of serum microRNAs in predicting pathology of retroperitoneal lymph node dissection in patients with testicular germ cell tumors: a systematic review and meta-analysis / $c M. Kardoust Parizi, N. Singla, S. Daneshmand, A. Heidenreich, A. Bagrodia, V. Margulis, A. Matsukawa, I. Tsuboi, SF. Shariat
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$a PURPOSE: To evaluate the diagnostic efficacy of serum microRNAs in predicting pathologic findings of retroperitoneal lymph node dissection (RPLND) in patients with testicular germ cell tumors (TGCT). METHODS: PUBMED, SCOPUS, and Cochrane Library were searched in August 2024 to identify eligible studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. RESULTS: Nine studies comprising 603 patients were selected in this review. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of microRNA-371a-3p for predicting viable tumor other than pure teratoma in RPLND specimen were 0.76 (95% CI 0.49-0.90), 0.97 (95% CI 0.81-0.99) and 31.75 (95% CI 9.24-109.10), respectively. The pooled sensitivity for primary and post-chemotherapy RPLND (PC-RPLND), were 0.77 (95% CI 0.47-0.93) and 0.73 (95% CI 0.28-0.95), respectively. The pooled specificity for primary and PC-RPLND were 0.92 (95% CI 0.72-0.98) and 0.99 (95% CI 0.62-1.00), respectively. The pooled DOR for primary and PC-RPLND were 13.86 (95% CI 2.97-64.79) and 64.11 (95% CI 13.09-313.98), respectively. The major limitation is the lack of standardization of miR371 testing. CONCLUSION: miR-371a-3p is a relatively sensitive and highly specific marker for predicting viable tumors in RPLND pathologic findings. The DOR was particularly significant for patients who underwent PC-RPLND. While serum microRNAs may be useful in distinguishing viable germ cell tumors from necrosis, fibrosis, and teratomas, their ability to differentiate teratomas from necrosis is limited. Well-designed prospective studies are essential to enhance our understanding of the predictive performance of microRNAs.
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$a Singla, Nirmish $u James Buchanan Brady Urological Institute, Johns Hopkins University, Baltimore, MD, USA
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$a Daneshmand, Siamak $u Department of Urology, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
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$a Heidenreich, Axel $u Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria $u Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany
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$a Bagrodia, Aditya $u Department of Urology, University of California San Diego, San Diego, CA, USA
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$a Margulis, Vitaly $u Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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$a Matsukawa, Akihiro $u Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria $u Department of Urology, Jikei University School of Medicine, Tokyo, Japan
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