Abstract
Previous studies have investigated the prognostic value of enhancer of zeste homolog 2 (EZH2) expression in patients with glioma but conclude contradictory results. We aimed to comprehensively evaluate the prognostic role of EZH2 in glioma by meta-analysis. The databases of PubMed, Embase and Web of Science were searched. Hazard ratio (HR) and 95% confidence interval (CI) were combined to assess the association between EZH2 and overall survival (OS) as well as progression-free survival (PFS). Odd ratio (OR) and 95% CI were calculated to investigate the relevance of EZH2 on clinical factors. Six studies with 575 patients were included for meta-analysis. The results showed that EZH2 overexpression was correlated with poor OS (n = 6, HR = 2.23, 95% CI: 1.56–3.19, p < 0.001) and PFS (n = 3, HR = 2.23, 95% CI: 1.56–3.19, p < 0.001). Subgroup analysis showed that EZH2 had enhanced prognostic value in Asian patients, for WHO grade I-IV and when using immunohistochemistry (IHC) method. In addition, EZH2 was associated with KPS score < 80. No evidence of publication bias was found in this meta-analysis. In conclusion, the present study showed that EZH2 was a potential prognostic marker for poor OS, PFS and lower KPS score in glioma patients.
Highlights
Brain tumors represent 1.9% of all new cancer cases and account for 2.3% of cancer related deaths globally [1]
All six studies investigated the prognostic value of enhancer of zeste homolog 2 (EZH2) for overall survival (OS) and three studies [16, 18, 19] explored the association between EZH2 and progressionfree survival (PFS)
Stratified analysis was conducted for further analysis, the results demonstrated that EZH2 still maintain prognostic value for poor OS in Asian patients (n = 3, Hazard ratio (HR) = 2.83, 95% confidence interval (CI): 1.88–4.26, p < 0.001), for World Health Organization (WHO) grade I-IV (n = 3, HR = 3.07, 95% CI: 1.1–8.57, p = 0.033) and by IHC method (n = 4, HR = 3.19, 95% CI: 1.39–7.3, p = 0.006)
Summary
Brain tumors represent 1.9% of all new cancer cases and account for 2.3% of cancer related deaths globally [1]. Approximately comprising 80% of all primary malignant brain tumors, is the most prevalent type and results in disappointing survival outcomes [2]. The treatment approaches mainly include surgical resection, radiotherapy, chemotherapy and multiple therapies in combination for glioma [3]. Much progresses have been achieved in glioma therapies, the prognosis of glioma is still frustrating, with most grade IV glioblastoma patients only surviving for less than 2 years [4]. It is necessary to identify molecular prognostic markers to help to tailor therapeutic regimens and to predict clinical outcomes of high risk patients
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