Blood-based circulating microRNAs as diagnostic biomarkers in cutaneous melanoma: a systematic review and meta-analysis

With the ever-increasing incidence of cutaneous melanoma (CM), early detection has become pivotal for ensuring patient survival. MicroRNAs (miRNAs) are promising diagnostic biomarkers owing to their stability and wide availability in various body fluids. This systematic review and meta-analysis evaluated the diagnostic performance of blood-based circulating free miRNAs and extracellular vesicle (EV)-derived miRNAs for CM. The study protocol was registered in PROSPERO (CRD420251125262). A total of 557 records were identified, with 11 studies included in the systematic review and 10 in the meta-analysis. Diagnostic performance was evaluated for all studies combined, and separately for individual miRNA and miRNA combinations. The bivariate model showed a pooled sensitivity of 0.86, specificity of 0.85, and diagnostic odds ratio (DOR) of 33.52. Separate analyses indicated that individual miRNAs yielded sensitivity, specificity, and DOR values of 0.80, 0.78, and 13.71, respectively. On the other hand, miRNA combinations achieved superior accuracy with a sensitivity of 0.91, specificity of 0.89, and DOR of 84.05. Subgroup analysis demonstrated that the plasma samples outperformed the other sample sources. Overall, circulating miRNAs exhibit strong potential as noninvasive diagnostic biomarkers for CM.