Correlation Between MicroRNA And Overall Survival Of Esophageal Cancer:A Meta-analysis

Background:Esophageal cancer is one of the most common malignant tumors in clinic.The main histological types include esophageal squamous cell carcinoma and esophageal adenocarcinoma.Because of the occult onset,most patients with dysphagia and other symptoms arealways found in the advanced stage and have lost the opportunity for further treatment,as a result,the survival rate of patients with esophageal cancer is very low and the mortality rate remains high.MicroRNA is a non-coding RNA with a length of less than25 nucleotides.It is stable in vitro and has higher sensitivity and specificity than traditional tumor markers.At present,a large number of studies have confirmed that the regulation of microRNA expression is related to the proliferation,migration and invasiveness of esophageal cancer cells,and ultimately affects the overall survival of patients with esophageal cancer through a variety of signaling pathways.Therefore,microRNA has great potential value in evaluating the overall survival of patients with esophageal cancer.Objective:To systematically evaluate the correlation between MicroRNA and overall survival of Esophageal Cancer.Methods:Retrieved the databases like PubMed,Embase,Cochrane,Web of Science,CBMdisc,CNKI,VIP and WangFang Database for collecting researchs about correlation between microRNA and overall survival of Esophageal Cancer,and the retrieval time was from the setup time of the databases to December,2018.Two researchers respectively assessed those literatures according to inclusion and exclusion criteria,then used the NOS quality to evaluate them,and finally the meta-analysis was conducted by using stata 15.0 software.The main contents of the analysis include heterogeneity analysis(evaluating whether the results included in the literature can be merged,determining which model to use for forest map analysis),forest plots and sensitivity analysis(excluding an article from the literatures one by one to get the merged results of the remaining literatures'data,and judging the stability of the included literatures according to the difference between the data and the original results.Publication bias test(using funnel plot,Egger test and Begg test).Results:The meta-analysis included 15 literatures,including 1406subjects.For heterogeneity analysis,the P value of Q-test of the four groups(microRNA21,microRNA203,microRNA145 and microRNA375)are all greater than 0.1 and I~2 are less than 50%,the heterogeneity of the literature is relatively small and Fixed-effect model can be used for meta-analysis.According to the forest plots,the risk ratio(HR)of combined overall survival(OS)of microRNA21,microRNA203,microRNA145 and microRNA375 in patients with esophageal cancer was 1.58(95%CI:1.18-1.98,P<0.01).In the subgroup analysis of different types of microRNAs for prognosis of esophageal cancer,high expression of microRNA21(HR=1.65,95%CI:1.23-2.07,P<0.01)and low expression of microRNA203(HR=2.36,95%CI:1.15-3.57,P<0.01),microRNA375(HR=1.64,95%CI:1.17–2.11,P<0.01)had significantly poorer OS.The higher expression of microRNA145(HR=0.51,95%CI:0.21-0.82,P<0.01)tended to have better OS.Sensitivity analysis of the included literatures shows that there is no significant change in the results after excluding the relevant literatures one by one,indicating that the included literatures have good stability.In the detection of publication bias,according to the funnel plot drawn according to the included literature,the results of Egger test and Begg test(P value is greater than 0.05),publication bias can not be considered.Conclusion:The expression of microRNA21,microRNA203,microRNA145 and microRNA375 may play an important role in the overall survival of esophageal cancer.The high expression of microRNA21 and the low expression of microRNA203 and microRNA375 may indicate the poor OS of patients with esophageal cancer.Patients with higher expression of microRNA145 tended to have better OS.