Research Paper Volume 13, Issue 15 pp 19657—19677

Diagnostic performance of microRNAs in testicular germ cell tumors: a systematic review and meta-analysis

Xi-Yi Zhao1, *, , Yu-Lu Gao1,2, *, , Dan-Feng Li1, , Hong-Chao Liu1, , Rui-Fang Zhu3, , Chang-Tai Zhu1, ,

  • 1 Department of Laboratory Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
  • 2 Department of Laboratory Medicine, Kunshan Affiliated Hospital of Nanjing University of Chinese Medicine, Kunshan 215300, China
  • 3 Editorial Department, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
* Equal contribution

Received: March 22, 2021       Accepted: July 15, 2021       Published: August 3, 2021
How to Cite

Copyright: © 2021 Zhao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


The sensitivity (Sen) of classic biomarkers for the diagnosis of testicular germ cell tumors (TGCTs) is currently low. Previous studies have shown the diagnostic potential of microRNAs (miRNAs) for TGCTs; however, the results of these studies are inconsistent. Therefore, we conducted a systematic review and meta-analysis to evaluate their diagnostic value. PubMed, EMBASE, Cochrane Library, and Web of Science databases were systematically searched until September 30, 2020 and 18 trials from 11 studies involving 2,068 participants were included in this meta-analysis. Using a bivariate mixed-effects meta-analysis model, the pooled Sen, specificity (Spe), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) with 95% confidence interval values of total miRNAs were 0.83 (0.73–0.90), 0.95 (0.89–0.98), 15.79 (7.41–33.66), 0.18 (0.11–0.29), 87.13 (41.99–180.82), and 0.95 (0.93–0.97), respectively; however, the observed values of single miR-371a-3p were  0.84 (0.76–0.90), 0.95 (0.91–0.98), 18.41 (9.69–34.97), 0.17 (0.11–0.26), 111.56 (47.72–260.80), and 0.97 (0.95–0.98), respectively. Subgroup analysis revealed that miRNAs that included miR-371a-3p showed higher predictive performance than those that did not (P < 0.05). This research identified that miR-371a-3p has a high diagnostic value for TGCTs, except teratoma.


miRNA: MicroRNA; TGCT: Testicular Germ Cell Tumors; AFP: α-fetoprotein; Sen: Sensitivity; SE: Seminoma; Spe: Specificity; NMTD: Non-Malignant Testicular Disease; QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies-2; PLR: Positive Likelihood Ratio; NLR: Negative Likelihood Ratio; DOR: Diagnostic Odds Ratio; AUC: Area Under The Curve; CI: Confidence Interval; ROC plane: Receiver Operating Characteristic Space; GCNIS: Germ Cell Neoplasia In Situ; NS: Non-Seminoma.