Circulating serum miRNAs as non-invasive biomarkers for early metastatic detection in cervical cancer: a meta-analysis

Rahmatusyifa; Astia Anelia; Wimbi Kartika Ratnasari

doi:10.22146/inajbcs.v57i3.Supplement.24289

Rahmatusyifa
Astia Anelia Master’s Programme in Biomedical Sciences, Faculty of Medicine, Nursing, and Public Health, Universitas Gadjah Mada, Yogyakarta, Indonesia
Wimbi Kartika Ratnasari Master’s Programme in Biomedical Sciences, Faculty of Medicine, Nursing, and Public Health, Universitas Gadjah Mada, Yogyakarta, Indonesia

DOI: https://doi.org/10.22146/inajbcs.v57i3.Supplement.24289

Keywords: Biomarker, Cervical cancer, Circulating serum miRNA, Early Detection, Metastasis

Abstract

Cervical cancer is the fourth most common cancer among women, with 660,000 new cases and 350,000 deaths globally. In Indonesia, 36,964 cases have been reported, projected to increase to 38,750 by 2025. Metastasis, occurring in up to 35% of late-stage cervical cases, is the leading cause of poor prognosis. This study
aimed to evaluate circulating serum miRNAs as non-invasive biomarkers for early metastatic detection in cervical cancer. A total of 1,088 publications were screened from five databases (PubMed, Scopus, Elsevier, Web of Science, and Google Scholar). Meta-analysis was conducted on four outcomes: relative miRNA expression (SMD), overall survival (HR), FIGO stage (HR), and metastasis (HR or OR), using RevMan version 5.4. Risk of bias was assessed with the ROBINS-I tool. Pooled analysis of 637 serum samples showed significantly reduced expression of tumor suppressor miRNAs in cervical cancer compared to healthy controls (SMD =
–0.90; 95% CI: –1.28 to –0.51; P < 0.00001; I² = 18%) and elevated levels of oncomiRs (SMD = 2.31; 95% CI: 1.70-2.92; P < 0.00001; I² = 77%). High expression of oncomiRs was significantly associated with poorer overall survival (HR = 1.93; 95% CI: 1.42 to 2.62; P < 0.0001; I² = 0%) and higher FIGO stage (HR = 2.43; 95% CI: 1.10 to 5.43; P = 0.03; I² = 67%). Tumor suppressor miRNAs were significantly associated with a lower risk of lymph node metastasis (OR = 0.28; 95% CI: 0.15–0.55; P = 0.0002; I² =0%), while oncomiRs were associated with a higher risk (OR = 3.76; 95% CI: 2.02–7.01; P < 0.0001; I² = 0%). Circulating serum miRNAs are significantly correlated
with survival, FIGO stage, and lymph node metastasis, supporting their potential as non-invasive biomarkers for early metastatic detection in cervical cancer.