Wang Feng, Yu Tao, Ma Chengbin, Zhang Haifei, Zhang Zhiyu
Department of Orthopedics, the Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
Center for Translational Medicine, the Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
FEBS Open Bio. 2019 Oct;9(10):1744-1755. doi: 10.1002/2211-5463.12713. Epub 2019 Sep 3.
Ezrin is a member of the ezrin-radixin-moesin (ERM) protein family and has been shown to be associated with poor prognosis in patients with a variety of solid tumors. However, the clinical prognostic significance of ezrin in patients with bone and soft tissue sarcomas remains unclear. Here, we performed a systematic meta-analysis by searching PubMed, the Cochrane Library Database, EMBASE, the Web of Science, and the CBM, WanFang Med Online and CNKI databases. In total, 19 studies with a total of 1316 bone and soft tissue sarcoma patients were included. Pooled analyses showed that ezrin overexpression was correlated with a higher rate of tumor metastasis (OR 6.59, 95% CI: 2.84-15.33, P < 0.01, P < 0.01) and recurrence (OR 3.18, 95% CI: 1.88-5.37, P < 0.01, P < 0.01) and a more advanced tumor grade (OR 3.252, 95% CI: 1.371-7.715, P = 0.01, P = 0.03). Moreover, elevated ezrin expression could predict poor OS (HR 3.02, 95% CI: 2.35-3.89, P < 0.01, P < 0.01), MFS (HR 5.22, 95% CI: 2.08-13.08, P < 0.01, P < 0.01), and EFS (HR 1.07, 95% CI: 1.03-1.11, P < 0.01, P < 0.01). Subgroup analyses revealed the underlying sources of heterogeneity. Publication bias was observed in the analysis of metastasis. Sensitivity analysis revealed that the results were robust. Our findings indicated that ezrin overexpression was significantly correlated with poor survival and more advanced tumor progression in bone and soft tissue sarcomas, which suggests that ezrin might be a valuable prognostic biomarker and a potential therapeutic target.
埃兹蛋白是埃兹蛋白-根蛋白-膜突蛋白（ERM）家族的成员，已被证明与多种实体瘤患者的不良预后相关。然而，埃兹蛋白在骨肉瘤和软组织肉瘤患者中的临床预后意义仍不明确。在此，我们通过检索PubMed、Cochrane图书馆数据库、EMBASE、科学网以及中国生物医学文献数据库、万方医学在线和中国知网数据库进行了一项系统的荟萃分析。总共纳入了19项研究，涉及1316例骨肉瘤和软组织肉瘤患者。汇总分析表明，埃兹蛋白过表达与更高的肿瘤转移率（比值比6.59，95%置信区间：2.84 - 15.33，P < 0.01，P < 0.01）、复发率（比值比3.18，95%置信区间：1.88 - 5.37，P < 0.01，P < 0.01）以及更高级别的肿瘤分级（比值比3.252，95%置信区间：1.371 - 7.715，P = 0.01，P = 0.03）相关。此外，埃兹蛋白表达升高可预测较差的总生存期（风险比3.02，95%置信区间：2.35 - 3.89，P < 0.01，P < 0.01）、无远处转移生存期（风险比5.22，95%置信区间：2.08 - 13.08，P < 0.01，P < 0.01）和无事件生存期（风险比1.07，95%置信区间：1.03 - 1.11，P < 0.01，P < 0.01）。亚组分析揭示了异质性的潜在来源。在转移分析中观察到发表偏倚。敏感性分析表明结果可靠。我们的研究结果表明，埃兹蛋白过表达与骨肉瘤和软组织肉瘤患者的不良生存及更晚期肿瘤进展显著相关，这表明埃兹蛋白可能是一种有价值的预后生物标志物和潜在的治疗靶点。
