Tu Chao, Ren Xiaolei, He Jieyu, Zhang Chenghao, Chen Ruiqi, Wang Wanchun, Li Zhihong
Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
J Cancer. 2019 Oct 15;10(24):5992-6002. doi: 10.7150/jca.35113. eCollection 2019.
: This updated meta-analysis aimed to analyze available data to explore the prognostic value of long noncoding RNA breast cancer anti-estrogen resistance 4 (BCAR4) in various human malignancies. : Literature retrieval was performed by systematic searching several authoritative databases, including Pubmed, PMC database, Web of Science, the Cochrane Library, Embase, and CNKI database up to Feb 10, 2019. Data were extracted and subsequently crosschecked, and discrepancies were discussed to reach consensus. Quality of the eligible studies was evaluated by Newcastle-Ottawa Scale (NOS). The fixed- or random-effects model was used to calculate the pooled the hazard ratios (HRs) or odds ratios (ORs) and the 95% confidence interval (95% CI). Publication bias was detected by using Begg's funnel plot and Egger's test. : A total 1,128 cancer patients from thirteen studies were included and pooled in the present meta-analysis. High expression levels of BCAR4 were correlated with unfavorable overall survival (OS) (HR=2.23, 95% CI: 1.84-2.71), but not progression-free survival (PFS) (HR=1.30, 95% CI: 0.80-2.11). Subgroup stratified analysis showed that tumor type, sample size, follow-up months, and survival analysis method did not alter the predictive value of BCAR4 on OS in various cancers. Furthermore, elevated BCAR4 level was markedly correlated with advanced clinical stage (III/IV) (OR=3.28, 95% CI: 2.33-4.60), and dramatically predicted lymph node metastasis (OR=3.00, 95% CI: 1.95-4.63, <0.00001) and distant metastasis (OR=3.36, 95% CI: 1.88-5.98, <0.0001), but not associated with age, gender or tumor size. No obvious heterogeneity was noted for correlation between BCAR4 expression and OS across these studies. : High expression of BCAR4 was correlated with unfavorable overall survival outcome and clinical features including metastasis and progression, implicating an independent prognostic value for BCAR4 in human cancers.
本更新的荟萃分析旨在分析现有数据,以探讨长链非编码RNA乳腺癌抗雌激素耐药4(BCAR4)在各种人类恶性肿瘤中的预后价值。通过系统检索多个权威数据库进行文献检索,包括截至2019年2月10日的PubMed、PMC数据库、Web of Science、Cochrane图书馆、Embase和CNKI数据库。提取数据并随后进行交叉核对,讨论差异以达成共识。采用纽卡斯尔-渥太华量表(NOS)评估纳入研究的质量。使用固定效应或随机效应模型计算合并风险比(HRs)或比值比(ORs)以及95%置信区间(95%CI)。采用Begg漏斗图和Egger检验检测发表偏倚。本荟萃分析共纳入了来自13项研究的1128例癌症患者并进行汇总。BCAR4高表达与不良总生存期(OS)相关(HR=2.23,95%CI:1.84-2.71),但与无进展生存期(PFS)无关(HR=1.30,95%CI:0.80-2.11)。亚组分层分析表明,肿瘤类型、样本量、随访月数和生存分析方法均未改变BCAR4在各种癌症中对OS的预测价值。此外,BCAR4水平升高与晚期临床分期(III/IV期)显著相关(OR=3.28,95%CI:2.33-4.60),并能显著预测淋巴结转移(OR=3.00,95%CI:1.95-4.63,<0.00001)和远处转移(OR=3.36,95%CI:1.88-5.98,<0.0001),但与年龄、性别或肿瘤大小无关。在这些研究中,BCAR4表达与OS之间的相关性未发现明显异质性。BCAR4高表达与不良总生存结局以及包括转移和进展在内的临床特征相关,这表明BCAR4在人类癌症中具有独立的预后价值。