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. 2018 Jan;8(1):127-132.
doi: 10.3892/mco.2017.1484. Epub 2017 Nov 3.

Prognostic value of urokinase plasminogen activator system in non-small cell lung cancer: A systematic review and meta-analysis

Jia-Ju Lu  1 , Hong Guo  2 , Bo Gao  1 , Yun Zhang  1 , Qing-Ling Lin  2 , Jiang Shi  1 , Jing-Jing Liu  1 , Jian Liu  2
Affiliations

Prognostic value of urokinase plasminogen activator system in non-small cell lung cancer: A systematic review and meta-analysis

Jia-Ju Lu et al. Mol Clin Oncol. 2018 Jan.

Abstract

Current relevant research suggests there are significant differences between the expression of the urokinase plasminogen activator (uPA) system in cancer tissues and in normal tissues. However, the potential effectiveness of the uPA system as a prognostic biomarker of non-small cell lung cancer (NSCLC) remains unclear. In the present study, a systematic review and meta-analysis were performed to evaluate the relevance of the uPA system in the prognosis of patients with NSCLC. Using the PubMed, EMBASE, Web of Science and Cochrane Library databases, data from relevant academic journal articles were extracted and subjected to analysis. Associations between expression profiles pertaining to the uPA system and the overall survival (OS) of patients with NSCLC were analyzed. The study incorporated data from 11 independent journal articles and these reports included a total of 937 patients with NSCLC. The meta-analysis results revealed that increased expression of urokinase plasminogen activator (uPA) and PA inhibitor type 1 (PAI-1) exhibited no significant association with poor OS [hazard ratio (HR)-uPA=1.07 (0.87-1.31), P=0.53; HR-PAI-1=1.02 (0.63-1.65), P=0.94]. Similarly, reduced expression of PAI type 2 (PAI-2) did not significantly correlate with poor OS [HR-PAI-2=1.58 (0.64-3.90); P=0.32]. Notably, however, a significant association was observed between increased expression levels of uPA receptor (uPAR) and poor OS for NSCLC [HR-uPAR=1.50 (1.04-2.15); P=0.03]. Therefore, the expression of uPAR in the uPA system of patients with NSCLC could be used as a novel clinical biomarker to evaluate the prognosis of NSCLC. The utilization of this biomarker may provide a platform for the further development of targeted drugs for the treatment of NSCLC.

Keywords: hazard ratio; meta-analysis; non-small cell lung cancer; overall survival; uPA system.

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Figures

Figure 1.
Figure 1.
A flow chart indicating the selection process of studies for inclusion in meta-analysis.
Figure 2.
Figure 2.
Forest plot: uPA expression is associated with OS. uPA, urokinase plasminogen activator; OS, overall survival; HR, hazard ratio; CI, confidence interval.
Figure 3.
Figure 3.
Forest plot: PAI-1 expression is associated with OS. PAI-1, plasminogen activator inhibitor type 1; OS, overall survival; HR, hazard ratio; CI, confidence interval.
Figure 4.
Figure 4.
Forest plot: PAI-2 expression is associated with OS. PAI-2, plasminogen activator inhibitor type 2; OS, overall survival; HR, hazard ratio; CI, confidence interval.
Figure 5.
Figure 5.
Forest plot: uPAR expression is associated with OS. uPAR, urokinase plasminogen activator receptor; OS, overall survival; HR, hazard ratio; CI, confidence interval.
Figure 6.
Figure 6.
Publication bias of uPAR (Funnel plot). uPAR, urokinase plasminogen activator receptor.
See this image and copyright information in PMC

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