Abstract
Increased glycolysis is one of the hallmarks of cancer. The abnormal expression of glucose transporter 1 (GLUT1) was reported to be associated with resistance to current therapy and poor prognosis. Numerous studies have investigated the correlation between GLUT1 expression and prognosis in cancers, but the conclusions are still controversial. Here, we conducted a meta-analysis to explore the association between GLUT1 and survival in human cancers. PubMed, Springer, Medline, and Cochrane Library were searched carefully to identify eligible studies evaluating prognostic value of GLUT1 in cancers. Twenty-seven studies with 4079 patients were included in the present study. Our pooled results identified that increased expression of GLUT1 was associated with unfavorable overall survival (HR = 1.780, 95% CI = 1.574–.013, p < 0.001)) and poorer disease-free survival (HR = 1.95, 95% CI = 1.229–3.095, p = 0.003). Furthermore, overexpression of GLUT1 linked with poor differentiated tumors (RR = 1.380, 95% CI = 1.086–1.755, p = 0.009; I2 = 72.0%, p < 0.001), positive lymph node metastasis (RR = 1.395, 95% CI = 1.082–1.799, p = 0.010; I2 = 70.8%, p = 0.002) and larger tumor size (RR = 1.405, 95% CI = 1.231–1.603, p < 0.001; I2 = 37.3%, p = 0.093). This systematic review and meta-analysis indicated that the GLUT1 may serve as an ideal prognostic biomarker in various cancers.
Highlights
Tumor cells exhibit an altered metabolism to support their fury proliferation under robust environment
Our pooled results identified that increased expression of GLUT1 was associated with unfavorable overall survival (HR = 1.780, 95% confidence interval (CI) = 1.574–.013, p < 0.001)) and poorer disease-free survival (HR = 1.95, 95% CI = 1.229–3.095, p = 0.003)
Sixteen studies investigated the association between GLUT1 level and overall survival (OS) [7,8,9,10,11, 15,16,17,18,19,20,21, 24, 27, 28, 30], while four studies investigated the association between GLUT1 and disease-free survival (DFS) [5, 13, 23, 26]
Summary
Tumor cells exhibit an altered metabolism to support their fury proliferation under robust environment. Increased need for glycolysis, known as Warburg effect, and glucose uptake for energy production were identified in various cancers [1]. Oxidative catabolism was more efficient in ATP production, glycolysis was identified increased along with upregulation of glucose transporters. Recent studies have showed that overexpression of glucose transporters (GLUTs), a protein family responsible for glucose uptake, resulted in enhanced aerobic glycolysis of cancers [2]. GLUT1 is a representative protein of GLUT family and is widely distributed in normal tissues. GLUT1 is primarily undetectable in normal epithelial tissues and benign epithelial tumors. Overexpression of GLUT1 during the oncogenesis has been identified in various cancers, which results in increased glucose uptake into cytoplasm of tumor cells [4]
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