Abstract
Accumulating evidence indicates that aberrant regulation of metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1), a long noncoding RNA (lncRNA), plays a vital role in tumorigenesis. However, its association with breast cancer has not been systematically evaluated. In the current study, a meta-analysis was conducted to clarify the association between MALAT-1 and the prognosis and clinicopathological features of breast cancer. Relevant literature published in several databases was searched. Hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI) were calculated to evaluate the effect of MALAT-1 expression on the survival outcomes and clinicopathological features of breast cancer. A total of 12 studies involving 4106 patients were identified. Pooled HR demonstrated that elevated MALAT-1 expression significantly predicted unfavorable overall survival (HR = 2.06, 95% CI: 1.66–2.56, P<0.0001) in patients with breast cancer. Subgroup analysis stratified by cancer type, sample size, and method of variance analysis also showed statistically significant associations. Additionally, the HR of patients with up-regulated MALAT-1 expression concerning disease-free survival (DFS), recurrence-free survival (RFS), and disease-specific survival (DSS) was 1.91 (95% CI: 1.53–2.39, P<0.0001). Further, elevated MALAT-1 expression was positively correlated with the progesterone receptor (PR) status (OR = 1.47, 95% CI: 1.18–1.82). Thus, MALAT-1 is a promising biomarker for predicting survival outcomes in patients with breast cancer.
Highlights
Breast cancer is the most common malignancy affecting females, and substantial progress in terms of its management has been made, it still remains the major cause of cancer-related deaths among females worldwide due to recurrence and metastasis [1,2]
Elevated metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1) expression levels in breast cancer were reported in most studies, except in one study that reported the down-regulation of MALAT-1 [18]
Huang et al divided all patients into groups based on receptor status, with estrogen receptor (ER)-positive or -negative groups [23], and Jadaliha et al did not report a negative result in all patients but mentioned the survival outcomes in the lymph node-negative triple-negative breast cancer (TNBC) and human epidermal growth factor receptor 2 (HER2)-positive breast cancer subsets [24]
Summary
Breast cancer is the most common malignancy affecting females, and substantial progress in terms of its management has been made, it still remains the major cause of cancer-related deaths among females worldwide due to recurrence and metastasis [1,2]. Breast cancer is a heterogeneous disease that exhibits considerable variability in its prognostic patterns and treatment response [3,4]. Molecular biomarkers have been identified as promising candidates and may predict the biological behavior and clinical outcome and contribute to the improvement of treatment protocols [5,6,7]. LncRNAs have been found to be consistently dysregulated and closely related to carcinogenesis and tumor progression in many cancers including liver, pancreas, colon, lung, prostate, and breast cancers [10]. Several lncRNAs are considered to be promising prognostic markers in cancer [11,12]
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