| Objectives : Gastrointestinal cancer(GIC)is one of the major diseases threatening human health,which mainly include esophageal cancer(EC),gastric cancer(GC)and colorectal cancer(CRC).At present,there is a lack and urgent need of an effective method to evaluate the prognosis of gastrointestinal cancer patients,and long non-coding RNA(lncRNA)is one of the most potential factors in tumor-related studies,therefore,the purpose of this study was to clarify the prognostic value of lncRNA in GIC through meta-analysis,to provide evidence-based evidence for the clinical value of lncRNA,and to provide possible basis for future research direction through systematic review and summary of previous studies.Methods:The two researchers independently searched the literatures published in the electronic database Pub Med,Web of Science and EMBASE before August 27,2018,and screened the relevant literatures according to the inclusion and exclusion criteria to include the relevant studies that met the criteria.By summarizing the characteristics of the included studies and relevant survival data,the Kaplan-Meier survival curve was extracted by Engauge Digitizer 4.1 or the survival related data was directly obtained from the original text,the survival related data was statistically analyzed by Review Manager 5.2,and the pooled hazard ratio(HR)and corresponding 95% confidence interval(CI)of overall survival(OS)and disease free survival(DFS)were calculated with random-effect and fixed-effect model to explore the relationship between lncRNAs expression and survival.Moreover,heterogeneity and publication bias were analyzed with forest plots and funnel plots.Results: A total of 111 articles were included and 13103 patients(3123 with esophageal cancer,4972 with gastric cancer and 5008 with colorectal cancer)were enrolled in this study.The pooled HR and corresponding 95%CI of OS related to lncRNA-UCA1 expression in GIC was 2.42(1.68-3.49);The pooled HR and corresponding 95%CI of OS related to different lncRNAs expression in esophageal,gastric,colorectal and gastrointestinal cancer patients were 1.92(1.70-2.16),1.96(1.77-2.16),2.10(1.87-2.36)and 2.00(1.87-2.13),respectively;The pooled HR and corresponding 95%CI of DFS related to different lncRNAs expression in GIC was 1.92(1.73-2.14).We have identified74 lncRNAs were associated closely with poor prognosis of GIC patients,including 58 significantly up-regulated expression lncRNAs(lncRNA SNHG20,lncRNA PVT1,lncRNA FEZF1-AS1,lncRNA AGAP2-AS1,lncRNA XIST,etc.)and 16 significantly down-regulated expression lncRNAs(lncRNA GAS5,lncRNA LINC00261,lncRNA lnc-GNAT1-1,lncRNA FER1L4,lncRNA MEG3,etc.).In addition,47 of included studies revealed relative mechanisms,specific targets of 37 lncRNAs were summarized and 12 of included studies investigated the correlation between lncRNAs and micro RNAs.Conclusions : This meta-analysis supports that specific lncRNAs are significantly related to the prognosis of GIC patients and may serve as novel biomarkers for predicting the prognosis of GIC patients.Furthermore,lncRNA-UCA1 may be a oncogene and can be used as a candidate tumor molecular marker to predict the prognosis of gastrointestinal cancer patients.In the future,lncRNAs as tumor markers may play an important role in promoting the development of targeted therapy,and help clinicians to make optimal and personalized clinical decisions. |
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