Abstract
Recent studies have highlighted the value of microRNA-21 (miR-21) as a prognostic biomarker in gliomas. However, the role of miR-21 in predicting prognosis remains controversial. We performed a comprehensive study based upon a meta-analysis and The Cancer Genome Atlas (TCGA) glioma dataset validation to clarify the prognostic significance of miR-21 in glioma patients. In this study, we searched Embase, PubMed, Web of science, CNKI, SinoMed, and Wanfang databases for records up to May 2018. Relevant data were extracted to assess the correlation between miR-21 expression and survival in glioma patients. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to describe association strength. We further used multivariate Cox regression analysis to assess miR-21 expression in the TCGA glioma dataset to validate the relationship between miR-21 expression and survival. Nine studies were included in the meta-analysis. Among them, eight studies provided data on overall survival (OS) with a pooled HR of 1.91 (95% CI: 1.34, 2.73), indicating that higher expression of miR-21 was significantly associated with worse OS in glioma patients; for the other study, which provided data on progression-free survival (PFS), no statistically significant HR was reported for PFS in the glioma patients (HR = 1.23, 95% CI: 0.41, 3.72). A multivariate Cox regression analysis of the miR-21 expression in the TCGA glioma dataset revealed that overexpression of miR-21 was a potential independent prognostic biomarker of poorer OS (HR = 1.27, 95% CI: 1.01, 1.59) and poorer PFS (HR = 1.46, 95% CI: 1.17, 1.82). Our findings suggest that higher expression of miR-21 is correlated with poorer glioma prognosis.
Highlights
Gliomas are one of the most common central nervous system (CNS) glial neoplasms, accounting for 30% of all CNS tumors and 80% of malignant brain tumors[1], respectively
Clinical factors alone are not sufficient to evaluate the prognoses of glioma patients, and further research is needed to search for better prognostic biomarkers
Previous studies have shown that the role of miR-21 in predicting the prognoses of glioma patients remains controversial, possibly because small sample sizes could have led to an inadequate statistical ability to detect certain relationships in individual studies
Summary
Gliomas are one of the most common central nervous system (CNS) glial neoplasms, accounting for 30% of all CNS tumors and 80% of malignant brain tumors[1], respectively. Studies have shown that miRNA expression is related to prognosis in patients with gliomas; for example, elevated expressions of microRNA-21 (miR-21), microRNA-10b (miR-10b), and microRNA-221/222 (miR-221/222) in patients with gliomas are correlated with shorter overall survival (OS) time[16,17,18]. This suggests that for the patients with gliomas, survival outcome can be predicted; miRNA expression may be clinically useful for management and prognosis. We performed an updated literature-based meta-analysis and analyzed the miR-21 levels obtained from the TCGA database We performed an updated literature-based meta-analysis and analyzed the miR-21 levels obtained from the TCGA database (https://portal.gdc.cancer. gov/) to elucidate the prognostic significance of miR-21 expression in glioma patients
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