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2016 ; 15
(1
): 50
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Long noncoding RNAs as novel predictors of survival in human cancer: a systematic
review and meta-analysis
#MMPMID27352941
Serghiou S
; Kyriakopoulou A
; Ioannidis JP
Mol Cancer
2016[Jun]; 15
(1
): 50
PMID27352941
show ga
BACKGROUND: Expression of various long noncoding RNAs (lncRNAs) may affect cancer
prognosis. Here, we aim to gather and examine all evidence on the potential role
of lncRNAs as novel predictors of survival in human cancer. METHODS: We
systematically searched through PubMed, to identify all published studies
reporting on the association between any individual lncRNA or group of lncRNAs
with prognosis in human cancer (death or other clinical outcomes). Where
appropriate, we then performed quantitative synthesis of those results using
meta-analytic methods to identify the true effect size of lncRNAs on cancer
prognosis. The reliability of those results was then examined using measures of
heterogeneity and testing for selective reporting biases. RESULTS: Three hundred
ninety-two studies were screened to eventually identify 111 eligible studies on
127 datasets. In total, these represented 16,754 independent participants
pertaining to 53 individual and 6 grouped lncRNAs within a total of 19 cancer
sites. Overall, 83 % of the studies we identified addressed overall survival and
32 % of the studies addressed recurrence-free survival. For overall survival,
96 % (88/92) of studies identified a statistically significant association of
lncRNA expression to prognosis. Meta-analysis of 6 out of 7 lncRNAs for which
three or more studies were available, identified statistically significant
associations with overall survival. The lncRNA HOTAIR was by far the most broadly
studied lncRNA (n = 29; of 111 studies) and featured a summary hazard ratio (HR)
of 2.22 (95 % confidence interval (CI), 1.86-2.65) with modest heterogeneity
(I(2)?=?49 %; 95 % CI, 14-79 %). Prominent excess significance was demonstrated
across all meta-analyses (p-value?=?0.0003), raising the possibility of
substantial selective reporting biases. CONCLUSIONS: Multiple lncRNAs have been
shown to be strongly associated with prognosis in diverse cancers, but
substantial bias cannot be excluded in this field and larger studies are needed
to understand whether these prognostic information may eventually be useful.