环状 RNA（circRNAs）作为肺癌预后因素的作用：一项荟萃分析。
The role of circular RNAs (circRNAs) as a prognostic factor in lung cancer: a meta-analysis.
机构信息
BMed Science, School of Medicine, IMU University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, 57000, Malaysia.
Warwick Medical School, The University of Warwick, Coventry, CV4 7AL, UK.
出版信息
BMC Cancer. 2024 Aug 9;24(1):988. doi: 10.1186/s12885-024-12704-w.
BACKGROUND
Lung cancer is a leading cause of cancer-related death worldwide. Among various histological types of lung cancer, majority are non-small cell lung cancer (NSCLC) which account for > 80%. Circular RNAs (circRNAs) are widely expressed in various cancers including lung cancer and implicated in tumourigenesis and cancer progression. This study aimed to systematically evaluate the prognostic values of circRNAs in lung cancer.
METHODS
A systematic literature search was done in PubMed, Embase, and MEDLINE databases to select the eligible studies which reported the association between the expression of circRNAs and overall survival (OS) or disease-free survival (DFS) in histopathologically diagnosed lung cancer patients. The pooled hazard ratio (HR) and 95% confidence interval (CI) were assessed to determine the prognostic significance of circRNAs.
RESULTS
A total of 43 studies were eligible for this meta-analysis (MA). 39 different types of circRNAs were reported: 28 showing upregulating and 11 showing downregulating action in lung cancer. High expression of circRNAs with upregulating action in lung cancer was associated with worse prognosis and poor OS (HR 1.93, 95% CI [1.61-2.33], p < 0.00001). High expression of circRNAs with downregulating action in lung cancer was associated with favorable OS and prognosis (HR 0.73, 95% CI [0.58-0.94], p = 0.01). However, there was no statistically significant association between high and low expression of both upregulating and downregulating circRNAs and DFS (HR 1.44, 95% CI [0.92-2.24], p = 0.11).
CONCLUSIONS
This MA confirmed the pivotal role of circRNAs as important prognostic biomarkers for lung cancer, especially NSCLC. High expression of upregulating circRNAs is associated with poor prognosis; however, high expression of downregulating circRNAs is associated with favorable prognosis. Therefore, downregulatory action of circRNAs should be considered a promising treatment in the management of lung cancer, especially NSCLC.
背景
肺癌是全球癌症相关死亡的主要原因。在各种肺癌组织学类型中，大多数是非小细胞肺癌（NSCLC），占>80%。环状 RNA（circRNA）广泛存在于各种癌症中，包括肺癌，并与肿瘤发生和癌症进展有关。本研究旨在系统评估 circRNA 在肺癌中的预后价值。
方法
系统地在 PubMed、Embase 和 MEDLINE 数据库中进行文献检索，以选择报道 circRNA 表达与组织病理学诊断为肺癌患者总生存期（OS）或无病生存期（DFS）之间相关性的合格研究。评估合并风险比（HR）和 95%置信区间（CI）以确定 circRNA 的预后意义。
结果
共有 43 项研究符合本荟萃分析（MA）的纳入标准。报道了 39 种不同类型的 circRNA：28 种表现为上调，11 种表现为下调。肺癌中具有上调作用的 circRNA 高表达与预后不良和 OS 差相关（HR 1.93，95%CI [1.61-2.33]，p<0.00001）。肺癌中具有下调作用的 circRNA 高表达与 OS 和预后良好相关（HR 0.73，95%CI [0.58-0.94]，p=0.01）。然而，高表达和低表达的上调和下调 circRNA 与 DFS 之间无统计学显著相关性（HR 1.44，95%CI [0.92-2.24]，p=0.11）。
结论
本 MA 证实 circRNA 作为肺癌重要的预后生物标志物的关键作用，特别是 NSCLC。上调 circRNA 的高表达与预后不良相关；然而，下调 circRNA 的高表达与预后良好相关。因此，circRNA 的下调作用应被视为肺癌，特别是 NSCLC 管理中一种有前途的治疗方法。
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