Abnormally expressed long non-coding RNAs in prognosis of Osteosarcoma: A systematic review and meta-analysis

Abstract

BackgroundNumerous studies have reported the relationship between Long non-coding RNAs (LncRNAs) expression and prognosis of osteosarcoma, but less consensus has been reached. Our meta-analysis was conducted to quantitatively assess the relationship between the expression of LncRNAs, prognosis and clinical pathology in osteosarcoma development. MethodsPubMed,Embase,Web of Science,The Cochrane Library,SionMed,CNKI and WanFang databases were carefully searched to identify eligible studies. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate the prognostic significance of LncRNAs expression in osteosarcoma. Moreover, meta-regression analysis and subgroup analysis were carried out to explore the potential sources of heterogeneity. ResultsA total of 20 studies comprising 1749 patients were included in present meta-analysis. The results showed that the over-expression of LncRNA had a significant correlation with overall survival (OS) (HR = 2.16, 95% CI:1.68–2.79), and was not related to disease free survival (DFS) (HR = 0.71, 95% CI:0.05–9.53). Subgroup analysis further indicated that LncRNA transcription level was significantly associated with alkaline phosphatase (HR = 2.13, 95% CI:1.58–2.88) , tumor size (< 8/ ≥ 8:HR = 1.97, 95% CI: 1.55–2.62) , metastasis (yes/no: HR = 2.14,95% CI:1.15–3.97) , distant metastasis(presence/absence: HR = 4.02, 95% CI:3.05–5.23) and Enneking stage(IIA /IIB-III:HR = 3.2, 95% CI:2.48–4.14), but not associated with age (≤ 25/ > 25:HR = 1.01, 95% CI:0.78–1.3), gender(female/male: HR = 1.15, 95% CI: 0.96–1.37), tumor site (femur,tibia/elsewhere:HR = 1.15, 95% CI:0.94–1.4) and chemotherapy (yes/no: HR = 1.45, 95% CI:0.46–4.63). ConclusionsThis study demonstrated that abnormal LncRNAs expression might be potential prognostic markers to predict worse overall survival in osteosarcoma patients. However, the cut-off values may be the source of heterogeneity.