Prognostic value of microRNA expression in pancreatic ductal adenocarcinoma: a systematic review and meta-analysis
Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) ranks among the deadliest malignancies, with limited survival benefits despite recent therapeutic advances. Few prognostic biomarkers are available for PDAC monitoring in clinical practice. We conducted a meta-analysis to evaluate and synthesise evidence on the prognostic significance of miRNA expression in PDAC. Methods: The protocol was registered with PROSPERO (CRD42023463542). We conducted a systematic search in PubMed, CENTRAL, and Embase on January 27, 2026, to identify studies assessing miRNA expression levels in patients with PDAC with reported overall survival (OS) or progression-free survival (PFS) outcomes. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Prediction intervals (PI) were reported if feasible. Separate analyses were performed by miRNA functional categories: oncogenic, tumour suppressor, chemoresistance-related, metastasis-related, and dual-role miRNAs. Findings: A total of 142 studies, including 13,824 patients, were included. High expression of oncogenic miRNAs was associated with worse univariate OS (HR 1.70, 95% CI 1.38–2.10; 95% PI 0.63–4.57) and PFS (HR 2.25, 95% CI 1.63–3.10; 95% PI 1.11–4.55). High expression of chemoresistance-related miRNAs was associated with worse multivariate OS (HR 2.11, 95% CI 1.68–2.66; 95% PI 0.96–4.68) and PFS (HR 2.51, 95% CI 1.89–3.33; 95% PI 1.58–3.97). Between-study heterogeneity varied substantially across pooled analyses (I 2 range 0–94%). miRNA-21 was the most frequently studied individual biomarker and showed a consistent association with worse multivariate OS (HR 2.24, 95% CI 1.95–2.57; 95% PI 1.92–2.61). Interpretation: Elevated expression of oncogenic and chemoresistance-related miRNAs is associated with worse survival outcomes in PDAC. However, substantial heterogeneity and wide prediction intervals observed in several pooled analyses indicate variability in effect sizes across studies. Among the investigated biomarkers, miRNA-21 has shown the most consistent prognostic association and may represent the strongest candidate for future clinical implementation. Further validation and standardisation are required before miRNA profiling can be integrated into routine clinical practice. Funding: None to declare.
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BibTeX
@article{ulmann2026prognostic,
title = {{Prognostic value of microRNA expression in pancreatic ductal adenocarcinoma: a systematic review and meta-analysis}},
author = {Lőrinc Ulmann and Mahmoud Obeidat and Stefania Bunduc and Szilárd Váncsa and Boglárka Lilla Szentes and Maryam Saleh and Maya Baksay and Orsolya Dohán and Péter Hegyi and Ákos Szücs},
journal = {eBioMedicine},
year = {2026},
month = oct,
doi = {10.1016/j.ebiom.2026.106528},
url = {https://linkinghub.elsevier.com/retrieve/pii/S2352396426004123},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Prognostic value of microRNA expression in pancreatic ductal adenocarcinoma: a systematic review and meta-analysis
AU - Lőrinc Ulmann
AU - Mahmoud Obeidat
AU - Stefania Bunduc
AU - Szilárd Váncsa
AU - Boglárka Lilla Szentes
AU - Maryam Saleh
AU - Maya Baksay
AU - Orsolya Dohán
AU - Péter Hegyi
AU - Ákos Szücs
PY - 2026
DA - 2026/10/23
JO - eBioMedicine
DO - 10.1016/j.ebiom.2026.106528
UR - https://linkinghub.elsevier.com/retrieve/pii/S2352396426004123
AB - Background: Pancreatic ductal adenocarcinoma (PDAC) ranks among the deadliest malignancies, with limited survival benefits despite recent therapeutic advances. Few prognostic biomarkers are available for PDAC monitoring in clinical practice. We conducted a meta-analysis to evaluate and synthesise evidence on the prognostic significance of miRNA expression in PDAC. Methods: The protocol was registered with PROSPERO (CRD42023463542). We conducted a systematic search in PubMed, CENTRAL, and Embase on January 27, 2026, to identify studies assessing miRNA expression levels in patients with PDAC with reported overall survival (OS) or progression-free survival (PFS) outcomes. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Prediction intervals (PI) were reported if feasible. Separate analyses were performed by miRNA functional categories: oncogenic, tumour suppressor, chemoresistance-related, metastasis-related, and dual-role miRNAs. Findings: A total of 142 studies, including 13,824 patients, were included. High expression of oncogenic miRNAs was associated with worse univariate OS (HR 1.70, 95% CI 1.38–2.10; 95% PI 0.63–4.57) and PFS (HR 2.25, 95% CI 1.63–3.10; 95% PI 1.11–4.55). High expression of chemoresistance-related miRNAs was associated with worse multivariate OS (HR 2.11, 95% CI 1.68–2.66; 95% PI 0.96–4.68) and PFS (HR 2.51, 95% CI 1.89–3.33; 95% PI 1.58–3.97). Between-study heterogeneity varied substantially across pooled analyses (I 2 range 0–94%). miRNA-21 was the most frequently studied individual biomarker and showed a consistent association with worse multivariate OS (HR 2.24, 95% CI 1.95–2.57; 95% PI 1.92–2.61). Interpretation: Elevated expression of oncogenic and chemoresistance-related miRNAs is associated with worse survival outcomes in PDAC. However, substantial heterogeneity and wide prediction intervals observed in several pooled analyses indicate variability in effect sizes across studies. Among the investigated biomarkers, miRNA-21 has shown the most consistent prognostic association and may represent the strongest candidate for future clinical implementation. Further validation and standardisation are required before miRNA profiling can be integrated into routine clinical practice. Funding: None to declare.
SN - 2352-3964
ER -