Abstract
Background and Aims Circular RNA (circRNA) demonstrates potential biological application in various solid tumors. We intended to evaluate the diagnostic, prognostic, and clinicopathological value of circRNA for esophageal cancer (EC). Methods We screened relative studies from Pubmed, Embase, Web of Science, and Cochrane Library. The diagnostic role of circRNAs was testified by pooled sensitivity and specificity. Pooled odds ratio (OR) and pooled hazard ratio (HR) were computed to appraise the clinicopathological and prognostic value, respectively. Results There were total 15 articles suitable with our included criteria, in which 7 for diagnosis, 8 for prognosis, and 9 for clinicopathological features. The pooled sensitivity and specificity were 0.77 and 0.80, respectively, while the AUC was 0.85. Patients with aberrant expression of circRNAs had a 2.92-fold increased risk of developing EC. The proportion of EC patients with normal circRNA expression only accounted for 29%. Upregulated expression of oncogenic circRNA was correlated with poor clinicopathological features, including lymph node metastasis, tumor size, and T classification, while downregulation of tumor-suppressor circRNA was contributed to worse TNM stage. As for prognosis, upregulated expression of circRNA carried out a diverse survival outcome, with a pooled HR of 2.76 for tumor promoter and that of 0.21 for tumor suppressor. High expression of oncogenic circRNA in both plasma and tumor tissue would lead to a shorter survival duration. Conclusion circRNAs might be a promising biomarker for diagnosis, prognosis, and clinicopathological features of EC.
Highlights
Circular RNA, consisting of a covalently closed circular structure without 5 ′ to 3 ′ polarity, is an endogenous noncoding RNA produced by unconventional splicing of pre-RNAs [1,2,3]
Upregulated tumorpromoter circRNA was correlated with worse OS (HR 2.76, 95% CI 2.09-3.63, Figure 6(a)) for esophageal cancer (EC) patients
For tumor-promoter circRNA, subgroup analysis declared that the high expression both in plasma (HR 2.52, 95% CI 1.56-4.09) and tissue
Summary
Circular RNA (circRNA), consisting of a covalently closed circular structure without 5 ′ to 3 ′ polarity, is an endogenous noncoding RNA produced by unconventional splicing of pre-RNAs [1,2,3]. It was initially discovered by Sanger et al [4] in 1976; it was proved to adsorb endogenous micro-RNAs (miRNAs) as miRNAs sponges in 2013 [5, 6]. Adenocarcinoma and squamous cell carcinoma are two most frequent histologic types of EC The former occurs mainly in developed countries, and the latter occurs mostly in Eastern Asia [12, 13].
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