Graduate School of Peking Union Medical College, China-Japan Friendship Institute of Clinical Medicine, Chaoyang District, Beijing 100029, China.
Department of Orthopedics, Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.
Biomed Res Int. 2018 Nov 25;2018:6124927. doi: 10.1155/2018/6124927. eCollection 2018.
Previous literatures have investigated the change of miR-20a expression level in the progression of multiple cancers and its influence on patients' survival outcome, but results of now-available evidence are inconsistent.
To elucidate the prognostic value of circulating and tissue-based miR-20a for patients with various cancers.
A systematic search and review of eligible publications were carried out in three electronic databases including the Cochrane Library, PubMed, and Embase, and the methodological quality of included studies was assessed according to Newcastle-Ottawa Scale (NOS). Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for overall survival (OS), recurrence-free survival (RFS), disease-free survival (DFS), and progressive-free survival (PFS) of each study were pooled using a random effect model.
In total, 24 studies involving 4186 samples of multiple cancers published in 20 articles were included in the statistical analysis. As for circulating miR-20a, five kinds of cancers containing gastric cancer, lymphoma, glioblastoma, prostate cancer, and non-small-cell lung cancer reported upregulated level in patients compared with normal healthy control, and overexpressed circulating miR-20a could confer an unfavorable factor for OS (HR = 1.71, 95% CIs: 1.43 -2.04, < 0.01) and DFS (HR = 1.90, 95% CIs: 1.45-2.49, < 0.01). As for tissue-based samples, 6 kinds of malignancies including colorectal cancer, salivary adenoid cystic carcinoma, gallbladder carcinoma, colon cancer, gastrointestinal cancer, and alveolar rhabdomyosarcoma revealed upregulated miR-20a expression level compared with paired nontumorous tissue, of which high expression of miR-20a was significantly associated with poor OS (HR = 2.74, 95% CIs: 1.38-5.42, < 0.01) and DFS (HR = 2.68, 95% CIs: 1.32-5.45, < 0.01); meanwhile, other 5 tumors containing breast cancer, cutaneous squamous cell carcinoma, hepatocellular carcinoma, oral squamous cell carcinoma, and epithelial ovarian cancer demonstrated downregulated miR-20a expression level compared with benign tissue, of which low miR-20a expression was significantly related to shorter OS (HR = 3.48, 95% CIs: 2.00-6.06, < 0.01) and PFS/RFS (HR = 4.05, 95% CIs: 2.89-5.66, < 0.01).
Change of circulating and tissue-based miR-20a expression possesses vital prognostic implication for human cancers. Augmented expression of circulating miR-20a predicts poor survival outcome for patients with cancers. Tissue-based miR-20a level may be upregulated or downregulated depending on cancer types; in the former condition, high expression of tissue miR-20a is a risk factor for unfavorable prognosis and in the latter condition low expression of tissue miR-20a is associated with shorter survival.
先前的文献已经研究了 miR-20a 在多种癌症进展中的表达水平变化及其对患者生存结局的影响，但现有证据的结果并不一致。
阐明循环和组织 miR-20a 对各种癌症患者的预后价值。
在 Cochrane 图书馆、PubMed 和 Embase 这三个电子数据库中进行了系统的搜索和符合条件的文献综述，并根据 Newcastle-Ottawa 量表（NOS）评估纳入研究的方法学质量。使用随机效应模型汇总每个研究的总生存期（OS）、无复发生存期（RFS）、无病生存期（DFS）和无进展生存期（PFS）的风险比（HR）和相应的 95%置信区间（CI）。
共纳入 20 篇文章中的 24 项研究，涉及 4186 例多种癌症患者的样本。就循环 miR-20a 而言，五种癌症（胃癌、淋巴瘤、胶质母细胞瘤、前列腺癌和非小细胞肺癌）的患者循环 miR-20a 水平高于健康对照，高表达的循环 miR-20a 对 OS（HR = 1.71，95%CI：1.43-2.04，<0.01）和 DFS（HR = 1.90，95%CI：1.45-2.49，<0.01）具有不利影响。就组织样本而言，六种恶性肿瘤（结直肠癌、涎腺腺样囊性癌、胆囊癌、结肠癌、胃肠道癌和肺泡横纹肌肉瘤）与配对的非肿瘤组织相比，miR-20a 表达水平升高，其中 miR-20a 高表达与 OS（HR = 2.74，95%CI：1.38-5.42，<0.01）和 DFS（HR = 2.68，95%CI：1.32-5.45，<0.01）不良预后显著相关；同时，其他五种肿瘤（乳腺癌、皮肤鳞状细胞癌、肝细胞癌、口腔鳞状细胞癌和上皮性卵巢癌）与良性组织相比，miR-20a 表达水平降低，其中 miR-20a 低表达与 OS（HR = 3.48，95%CI：2.00-6.06，<0.01）和 PFS/RFS（HR = 4.05，95%CI：2.89-5.66，<0.01）较短显著相关。
循环和组织 miR-20a 表达的变化对人类癌症具有重要的预后意义。循环 miR-20a 的升高预示着癌症患者的生存结局不佳。组织 miR-20a 水平可能根据癌症类型而升高或降低；在前一种情况下，组织 miR-20a 高表达是预后不良的危险因素，在后一种情况下，组织 miR-20a 低表达与生存期较短相关。
