Systematic review and meta-analysis of the utility of long non-coding RNA GAS5 as a diagnostic and prognostic cancer biomarker
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Wei Li1, Na Li2, Ke Shi1 and Qiong Chen1
1Department of Geriatrics, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
2Department of Pathology, The First Affiliated Hospital of Hunan University of Medicine, Huaihua 418000, Hunan Province, China
Ke Shi, email: [email protected]
Qiong Chen, email: [email protected]
Keywords: GAS5, cancer, clinical outcome, diagnosis, prognosis
Received: April 13, 2017 Accepted: June 20, 2017 Published: July 06, 2017
The growth arrest-specific 5 transcript (GAS5) is a long non-coding RNA (lncRNA) involved in the control of cell cycle progression and apoptosis in a wide variety of cells. To determine the clinical value of GAS5 expression in cancer patients, we performed a systematic review and meta-analysis exploring its association with the diagnosis, prognosis, and clinicopathological characteristics of cancer. Ten articles on prognosis, 15 on clinicopathology, and 5 on diagnosis were analyzed. Overall results showed that decreased GAS5 expression associated with unfavorable overall survival (OS) (HR = 2.50, 95%CI: 1.85–3.38, P < 0.001) and disease-free survival (DFS) (HR = 2.24, 95%CI: 1.58–3.18, P < 0.001) in several tumor types. Down-regulation of GAS5 correlated with poor recurrence-free survival (RFS) in hepatocellular carcinoma (HR = 2.40, 95%CI: 1.27–4.54, P = 0.007), and was associated with lymph node metastasis (OR = 1.92, 95% CI: 1.44–2.57, P < 0.001), distant metastasis (OR = 2.7, 95% CI: 1.05–6.97, P = 0.040), poor clinical stage (OR = 0.26, 95% CI: 0.18–0.38, P < 0.001), larger tumor size (OR = 3.21, 95% CI: 2.08–4.95, P < 0.001), and poor tumor differentiation (OR = 1.98, 95% CI: 1.40–2.80, P < 0.001). Pooled results of diagnostic data analysis showed that GAS5 exhibited a sensitivity of 0.76 and specificity of 0.64 for cancer diagnosis, and an area under the curve of 0.76 (95% CI: 0.72–0.80) indicated moderate diagnostic accuracy. This meta-analysis suggests GAS5 lncRNA may be a useful diagnostic and prognostic cancer biomarker, and may be especially useful for identifying patients prone to developing lymph node or distant metastasis.
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