Upregulated SOX9 expression indicates worse prognosis in solid tumors: a systematic review and meta-analysis

Haihua Ruan, Shuangyan Hu, Hongyu Zhang, Gang Du, Xiaoting Li, Xiaobo Li and Xichuan Li _

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Oncotarget. 2017; 8:113163-113173. https://doi.org/10.18632/oncotarget.22635

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Haihua Ruan1, Shuangyan Hu1, Hongyu Zhang1, Gang Du1, Xiaoting Li2, Xiaobo Li2 and Xichuan Li1,2

1Tianjin Key Laboratory of Food Science and Biotechnology, College of Biotechnology and Food Science, Tianjin University of Commerce, Tianjin, China

2Department of Immunology, Tianjin Medical University, Tianjin, China

Correspondence to:

Xichuan Li, email: [email protected]

Hongyu Zhang, email: [email protected]

Keywords: solid tumors, SOX9, prognosis, meta-analysis

Received: August 23, 2017     Accepted: October 05, 2017     Published: November 06, 2017


It was recently reported that increased SOX9 expression drives tumor growth and promotes cancer invasion during human tumorigenicity and metastasis. However, the prognostic value of SOX9 for the survival of patients with solid tumors remains controversial. The present meta-analysis was thus performed to highlight the link between dysregulated SOX9 expression and prognosis in cancer patients. A systematic literature search was conducted using the electronic databases PubMed, Web of Science and Embase to identify eligible studies. A random-effects meta-analytical model was employed to correlate SOX9 expression with overall survival (OS), disease-free survival (DFS) and clinicopathological features. In total, 17 studies with 3307 patients were eligible for the final analysis. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) suggested that high SOX9 expression has an unfavourable impact on OS (HR = 1.66, 95% CI 1.36–2.02, P < 0.001) and DFS (HR = 3.54, 95% CI 2.29–5.47, P = 0.008) in multivariate analysis. Additionally, the pooled odds ratios (ORs) indicated that SOX9 over-expression is associated with large tumor size, lymph node metastasis, distant metastasis and a higher clinical stage. Overall, these results indicated that SOX9 over-expression in patients with solid tumors might be related to poor prognosis and could serve as a potential predictive marker of poor clinicopathological prognosis factor.

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