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 Publisher Pubmed



Kardoust Parizi M^{1, 2} ; Singla N³ ; Daneshmand S⁴ ; Heidenreich A^{1, 5} ; Bagrodia A⁶ ; Margulis V⁷ ; Matsukawa A^{1, 8} ; Tsuboi I^{1, 9} ; Shariat SF^{1, 7, 10, 11, 12, 13, 14}
Source: World Journal of Urology Published:2025

Abstract

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. © The Author(s) 2025.