Prognostic value of Kindlin-2 expression in patients with solid tumors: a meta-analysis

Abstract

Background: Kindlin-2 is one of the Kindlin family members which are evolutionarily conserved focal adhesion proteins with integrin β-binding affinity. Recently, accumulative studies have suggested that Kindlin-2 plays important roles in tumor biology. However, the prognostic significance of Kindlin-2 in patients with solid tumors remains controversial. Therefore, this study aimed to clarify the prognostic value of Kindlin-2 in solid tumors via meta-analysis.

Methods: A comprehensive search was performed in PubMed, Embase, Web of Science and EBSCO for all relevant studies reporting the prognostic significance of Kindlin-2 expression in solid cancer patients. The summary hazard ratio (HR) and corresponding 95% confidence interval (CI) were calculated to estimate the association between Kindlin-2 expression with survival of solid cancer patients.

Results: We included 14 eligible studies containing 1869 patients in our meta-analysis. The pooled results indicated that high Kindlin-2 expression was significantly associated with poor overall survival (OS) (pooled HR 1.66, 95% CI 1.44-1.92, P < 0.0001), disease-free survival (DFS)/recurrence-free survival (RFS)/progression-free survival (PFS) (pooled HR 1.73, 95% CI 1.16-2.57, P = 0.0067). For certain tumor types, high Kindlin-2 expression was significantly correlated with a poor outcome in patients with solid tumors, including pancreatic ductal adenocarcinoma (DFS/RFS/PFS), esophageal squamous cell carcinoma (OS, DFS/RFS/PFS), hepatocellular carcinoma (OS), clear cell renal cell carcinoma (OS), bladder cancer (OS, DFS/RFS/PFS), chondrosarcoma (OS), osteosarcoma (OS), gastric cancer (DFS/RFS/PFS), and glioma (OS).

Conclusions: Our meta-analysis demonstrated that high Kindlin-2 expression might indicate poor outcome in patients with solid tumors and could serve as a prognostic biomarker for solid cancer patients.

Keywords: Cancer; Kindlin-2; Meta-analysis; Prognosis; Solid tumor.

Fig. 1

Flow diagram of the study selection process

Fig. 2

Forest plots of studies evaluating hazard ratios of high Kindlin-2 expression in solid tumors. Survival data were reported as a OS; b DFS/RFS/PFS. (I) This article (Yoshida [14]) was listed two cohort study because the sample types contain cancer tissue and startle cell. (II) and (III) This article (Cao [17]) included patients from generation dataset (II) and validation dataset (III)

Fig. 3

Forest plots of study subgroups according to the variables. Survival data were reported as (a–f) OS; g–l DFS/RFS/PFS. (I) This article (Yoshida [14]) was listed two cohort study because the sample types contain cancer tissue and startle cell. (II) and (III) This article (Cao [17]) included patients from generation dataset (II) and validation dataset (III)

Fig. 4

Forest plots of study groups sorted according to specific tumor types. Survival data were reported as a OS; b DFS/RFS/PFS. (I) This article (Yoshida [14]) was listed two cohort study because the sample types contain cancer tissue and startle cell. (II) and (III) This article (Cao [17]) included patients from generation dataset (II) and validation dataset (III)

Fig. 5

Funnel plots for assessing the publication bias. a Original data, b data rectified by the trim and filled model. (I) This article (Yoshida [14]) was listed two cohort study because the sample types contain cancer tissue and startle cell. (II) and (III) This article (Cao [17]) included patients from generation dataset (II) and validation dataset (III)

Fig. 6

Sensitivity analysis on the prognostic value of Kindlin-2 expression in solid tumors patients. Note: Survival data were reported as a OS; b DFS/RFS/PFS. (I) This article (Yoshida [14]) was listed two cohort study because the sample types contain cancer tissue and startle cell. (II) and (III) This article (Cao [17]) included patients from generation dataset (II) and validation dataset (III)