Abstract
Objective: Numerous epidemiological studies have reported the association between silent mating type information regulation 2 homolog-1 (SIRT1) and female reproductive system cancer, but the data of different reports remains controversial. To accurately evaluate the significance of SIRT1 expression in reproductive system cancer, a meta-analysis based on published studies was conducted. Methods: Relevant articles before August 2017 on SIRT1 and reproductive system cancer were searched via PubMed, Embase, Cochrane Central and Chinese National Knowledge Infrastructure databases(NCBI). The studies were chosen for the meta-analysis based on requisite criteria. The overall survival (OS) and clinical features including FIGO stage , lymph node metastasis (LNM) and tumor grade were analyzed using RevMan 5.3 software. Odds ratios (OR) , hazard ratios (HR) and their 95% corresponding confidence intervals (CI) were pooled to estimate the effect of specific associations. Results: A total of 14 eligible studies containing 1002 patients were enrolled, in which 47.9% of the patients overexpressed SIRT1. The results showed that SIRT1 overexpression significantly correlated with the risk of reproductive cancers (OR=3.92, 95% CI: 3.06–5.02, P<0.00001), histological grade (OR=2.47, 95% CI=1.19-5.13, p=0.02), LNM (OR=3.25, 95% CI=1.85-5.70, P<0.0001), but no statistical significance was related to FIGO stage (OR=1.84, 95% CI=1.00-3037, P=0.05) and overall survival (HR=1.32, 95% CI=1.00-1.75, P=0.05) of female reproductive system cancer. Conclusions: The overall data of the shown meta-analysis suggested that the expression of SIRT1 is correlated with cancer risk, lymph node metastasis and histological grade. However, the over-expression of SIRT1 have no statistical significance with FIGO stage and overall survival.
Highlights
Female reproductive system cancers are among the most threat to cancer-related death, which includes cervical cancer, ovarian cancer, and endometrial cancer
Publications were considered eligible in our quantitative meta-analysis when they met all of the following criteria: (1) The diagnosis of reproductive cancer was histologically and pathologically confirmed; (2) silent mating type information regulation homolog-1 (SIRT1) expression was determined by immunohistochemistry(IHC) in the tissues of reproductive system cancers; (3) Sufficient information of the correlation of SIRT1 with clinicopathological features or overall survival time was provided to estimate odds ratio (OR) and hazard ratio (HR); (4) Being written as full papers; Publications were excluded based on the following criteria: (1) The studies have no relevant with reproductive system cancers or SIRT1; (2) Studies lack of usable statistical data for further analysis; (3) duplicate or overlapping publications; (4) reviews, letters or case reports
Based to the a meta-analysis of SIRT1 overexpression related to prognosis of various solid tumors, wang [30] extracted data from 37 studies and found that elevated SIRT1 expression was significantly associated with shorter overall survival (OS) and RFS of solid malignancies
Summary
Female reproductive system cancers are among the most threat to cancer-related death, which includes cervical cancer, ovarian cancer, and endometrial cancer. Cervical cancer is the third most common diagnosed malignance and the fourth leading cause of cancer-related death in females worldwide [1], Ovarian cancer is the leading cause of mortality from gynecological malignancy [2], Endometrial cancer is the fifth most normally cancer among female worldwide which accounted for 4.8% of all female cancer cases [3]. Numerous of cell signaling pathways have been explored and studied, accumulating evidence has presented that epigenetic regulation of gene expression contributes highly to reproductive system malignancy [4].
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