Association Between Expression Of Transcription Factor Foxm1 And The Prognosis Of Tumor:A Meta-Analysis

Objective: Cancer is a huge risk factor for the health of mankind,and now the number of patients with cancer around the world are still increasing year by year,while the survival and prognosis of cancer patients is a serious problem to solve.Transcription factor FOXM1,recent years,is concerned in correlation with cancer survival and prognosis.However,there were not a systematic evaluation about all the existing researches.This study is a Meta-analysis on the survival and prognosis of cancer and FOXM1 expression,and intended to define the relationship between them,in order to further the FOXM1 as a predictor of survival and prognosis in patients with cancer.Methods: Follow the procedures and norms of Meta analysis,according to the strict inclusion and exclusion criteria,search comprehensively all relevant research.And then screening the researches and extract data and information.With hazard ratios(HRs)and 95% confidence intervals(CIs)as the evaluation criterions,a comprehensive analysis and calculation are made about the degree of association between FOXM1 gene expression and tumor survival and prognosis.Due to the special nature of cancer survival and prognosis,there are two indicators as overall survival(Overall survival,OS)and disease-free survival(Disease free survival,DFS)can be used to measure,so they were done each other.Using Q test and I2 statistic for heterogeneity test,selecting the appropriate data combined effect model based on the situation of the heterogeneity.And multiple subgroup were analyzed,to further refine the analysis of the linkages between them,as well as to explore the sources of heterogeneity.With sensitivity analysis to assess the stability of results.By plotting funnel plot to qualitative observation,and the Egger regression test was used to quantitatively evaluate the comprehensive publication bias.Results: The research included 40 studies with a total of 4789 cases in the cancer survival and prognostic indicator OS Meta analysis and 13 studies with a total of 2071 patients in cancer survival Meta analysis of prognostic indicator DFS.TheMeta analysis results of overall indicates that a poor survival prognosis is related with the high expression of FOXM1 in cancer patients,the results of HRs and 95% CIs were(1.90,95% CI: 1.72-2.09,P?0.001)and(1.98,95 % CI: 1.73-2.27,P ?0.001)respectively.The further analysis of heterogeneity,publication bias and sensitivity of the two indicators of the survival and prognosis OS and DFS showed that the studies included had no significant heterogeneity,individual studies had no significant effect on the overall index,the researches there were no significant publication bias.So that the Meta-analysis is stable and credible.Conclusion: The poor prognosis and survival of cancer patients is obviously related with the high expression of the transcription factor FOXM1.And FOXM1 is likely to act as a tumor poor prognostic and survival factor.