Circular RNA as Diagnostic and Prognostic Biomarkers in Hematological Malignancies:Systematic Review

While various serum and tissue biomarkers have been explored for tumor diagnosis, the sensitivity and specificity have not yield optimal results. Circular RNAs (circRNAs) are more stable, conserved, and tissue-specific than linear RNA. Recent reports indicate that circRNAs could serve as potential biomarkers in the diagnosis or/and prognosis of tumors. In this study, we systematically examined the relationship between circRNA expression and diagnostic and prognostic outcomes in patients with hematological tumors. We searched several databases, including Google Scholar, MEDLINE, Scopus, PubMed, Embase, ScienceDirect, Ovid-Medline, Chinese National Knowledge Infrastructure, WanFang and SinoMed, with a cutoff date of June 12, 2024. The study protocol was PROSPERO (CRD42020188627). A total of 73 studies were included in our review, comprising 39 diagnostic studies and 65 prognostic studies. Clinical parameters were assessed based on pooled adds ratios and 95% confidence intervals (CIs). Overall survival (OS) was evaluated using hazard ratios (HRs) and 95% CIs. The pooled area under the curve was 0.86, indicating the potential to identify hematological tumor patients, with sensitivity and specificity of 79% each. The diagnostic score for circRNAs related to hematological malignancies was 2.12. Notably, different hematological malignancies subgroups displayed varying prognoses. Specifically, lymphoid leukemia circRNA showed a negative impacct on prognosis (HR = 1.25, 95% CI: 1.10-1.43, P