The prognostic value of homeobox A9 (HOXA9) methylation in solid tumors: a systematic review and meta-analysis.

Abstract

BackgroundThe prognosis of homeobox A9 (HOXA9) methylation have been assessed in a variety of cancers; nevertheless, the results remain undetermined due to discrete outcome and the limitations of small sample size. Therefore, we conducted a meta-analysis to explore the effect of HOXA9 methylation on the prognostic outcomes of patients with solid tumors.MethodsQualified studies were verified by searching PubMed, Excerpta Medica Database and Web of Science until September, 2020. Clinicopathological factors and hazard ratio (HR) of 95% confidence interval (95% CI) were selected. Subgroup analysis including carcinoma category, analysis method and sample size were adopted.ResultsIn the meta-analysis 1,031 patients with solid carcinoma from 7 eligible investigations were involved. Among human cancer we discovered that the high HOXA9 methylation level was negative correlative with overall survival (OS) (HR =2.36; 95% CI: 1.70–3.26). In the subgroup analysis, we found HOXA9 methylation over-expression had statistical significance with poorer OS in lung cancer patients (HR =3.08, 95% CI: 1.70–5.55, P=0.002) and non-lung cancer (HR =2.10, 95% CI: 1.42–3.10, P=0.0002). Similar result was found in sample size. Greater than or equal to 100 (HR =2.31, 95% CI: 1.54–3.45, P<0.0001) and less than 100 (HR =2.45, 95% CI: 1.42–4.23, P=0.001).DiscussionHOXA9 methylation has a significantly estimable biomarker of predicting poor prognosis and a potential target for therapy in solid malignant carcinoma from our meta-analysis.