The Clinical Association Of NANOG With Solid Tumors And Its Prognostic Significance:A Meta Analysis

Purpose: NANOG is a tumor marker and indicates poor prognosis in some neoplasms.This meta-analysis was to study the relationship between the NANOG expression with clinicopathological characteristics and the survival of the patients with solid tumors.Methods: Studies were retrieved in PubMed,Web of Science,Embase and China National Knowledge Infrastructure from inaugural issue to October 17,2017.Data were extracted from the selected articles,and study quality was assessed and NANOG expression,survival outcomes,and clinicopathological characteristics from these studies were analyzed.Odds ratios(ORs)and hazard ratios(HRs)were calculated with 95% CIs.Results: Twenty-eight articles including 30 datasets of 3583 patients were analyzed.The results show that,the high expression of NANOG was associated with poor overall survival(HR = 2.17;95% CI: 1.83�2.59,p <0.001)and poor disease free survival(HR = 2.18,95% CI: 1.47�3.23,p =0.002).Subgroup analysis found that NANOG expression was associated with worse overall survival in non-small cell lung cancer(HR = 1.87;95%CI: 1.26�2.76,p = 0.002),head and neck cancer(HR = 2.44;95% CI:1.61�3.69,p < 0.001)and digestive system cancers(HR = 2.35;95% CI:1.89�2.93,p < 0.001).Moreover,we also found that high NANOG expression was associated with poor tumor differentiation(OR = 2.63;95%CI: 1.59�4.55,p < 0.001),lymph node metastasis(OR = 1.97;95% CI:1,06�3.65,p = 0.03),advanced TNM stage(OR = 2.13;95% CI: 1.35�3.45,p = 0.001),and lymphatic infiltration(OR = 1.64;95% CI: 1.07�2.49,p =0.02).Conclusion: Our study show that NANOG as a tumor biomarker to guide clinical management and indicate prognosis.Additional studies are needed to further validate these results.