高 CASC 表达预示着肺癌预后不良：一项系统评价和荟萃分析。
High CASC expression predicts poor prognosis of lung cancer: A systematic review with meta-analysis.
机构信息
Department of Thoracic Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Department of Thoracic Surgery, People's Hospital of Dongxihu District, Wuhan, Hubei, China.
出版信息
PLoS One. 2024 Apr 4;19(4):e0292726. doi: 10.1371/journal.pone.0292726. eCollection 2024.
BACKGROUND
The long non-coding RNA cancer susceptibility candidate (CASC) has abnormal expression in lung cancer tissues and may correlate with lung cancer prognosis. This study aimed to comprehensively evaluate the association between CASC expression and the cancer prognosis.
METHODS
PubMed, Embase, Web of Science, Google Scholar, Cochrane Library, and China National Knowledge Infrastructure databases were searched until April 1, 2023, to obtain the relevant literature. Studies that met the predefined eligibility criteria were included, and their quality was independently assessed by 2 investigators according to the Newcastle-Ottawa Scale (NOS) score. Detailed information was obtained, such as first author, year of publication, and number of patients. Hazard ratio (HR) with a 95% confidence interval (CI) was extracted and grouped to assess the relationship between CASC expression and cancer prognosis. The dichotomous data was merged and shown as the odds ratio (OR) with a 95% CI was extracted to assess the relationship between CASC expression and clinicopathological parameters.
RESULTS
A total of 12 studies with 746 patients with lung cancer were included in the meta-analysis. The expression levels of lncRNA CASC2 and CASC7 were decreased, while those of CASC9, 11, 15, and 19 were induced in lung cancer tissues compared with paracancerous tissues. In the population with low CASC expression (CASC2 and CASC7), high CASC expression indicated a good lung cancer prognosis (HR = 0.469; 95% CI, 0.271-0.668). Conversely, in the population with high CASC expression (CASC9, 11, 15, and 19), high CASC expression predicted a poor lung cancer outcome (HR = 1.910; 95% CI, 1.628-2.192). High CASC expression also predicted worse disease-free survival (DFS) (HR = 2.803; 95% CI, 1.804-6.319). Combined OR with 95% CI revealed an insignificant positive association between high CASC expression and advanced TNM stage (OR = 1.061; 95% CI, 0.775-1.454), LNM (OR = 0.962; 95% CI, 0.724-1.277), tumor size (OR = 0.942; 95% CI, 0.667-1.330), and histological grade (OR = 1.022; 95% CI, 0.689-1.517).
CONCLUSION
The CASC expression levels negatively correlate with lung cancer prognosis. Therefore, CASC expression may serve as a prognostic marker and a potential therapeutic target for lung cancer.
背景
长链非编码 RNA 癌症易感性候选物（CASC）在肺癌组织中表达异常，可能与肺癌预后相关。本研究旨在全面评估 CASC 表达与癌症预后之间的关联。
方法
检索 PubMed、Embase、Web of Science、Google Scholar、Cochrane Library 和中国国家知识基础设施数据库，以获取相关文献，截至 2023 年 4 月 1 日。根据纽卡斯尔-渥太华量表（NOS）评分，由 2 名研究者独立评估符合预设纳入标准的研究的质量。获取详细信息，如第一作者、发表年份和患者数量。提取风险比（HR）及其 95%置信区间（CI），并进行分组，以评估 CASC 表达与癌症预后之间的关系。合并二分类数据并以提取的优势比（OR）及其 95%CI 表示，以评估 CASC 表达与临床病理参数之间的关系。
结果
共有 12 项研究，纳入 746 例肺癌患者，进行了荟萃分析。与癌旁组织相比，肺癌组织中 lncRNA CASC2 和 CASC7 的表达水平降低，而 CASC9、11、15 和 19 的表达水平升高。在 CASC 低表达（CASC2 和 CASC7）人群中，CASC 高表达预示着较好的肺癌预后（HR=0.469；95%CI，0.271-0.668）。相反，在 CASC 高表达（CASC9、11、15 和 19）人群中，CASC 高表达预示着较差的肺癌结局（HR=1.910；95%CI，1.628-2.192）。CASC 高表达也预示着更差的无病生存期（DFS）（HR=2.803；95%CI，1.804-6.319）。合并 OR 及其 95%CI 显示，CASC 高表达与晚期 TNM 分期（OR=1.061；95%CI，0.775-1.454）、淋巴结转移（OR=0.962；95%CI，0.724-1.277）、肿瘤大小（OR=0.942；95%CI，0.667-1.330）和组织学分级（OR=1.022；95%CI，0.689-1.517）呈正相关，但无统计学意义。
结论
CASC 表达水平与肺癌预后呈负相关。因此，CASC 表达可能作为肺癌的预后标志物和潜在的治疗靶点。
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