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Meta-Analysis
. 2019 Jul 25;8(8):772.
doi: 10.3390/cells8080772.

Prognostic Value of miRNAs in Head and Neck Cancers: A Comprehensive Systematic and Meta-Analysis

Chellan Kumarasamy  1 , Madurantakam Royam Madhav  2 , Shanthi Sabarimurugan  2 , Sunil Krishnan  3 , Siddhartha Baxi  4 , Ajay Gupta  5 , K M Gothandam  2 , Rama Jayaraj  6
Affiliations
Meta-Analysis

Prognostic Value of miRNAs in Head and Neck Cancers: A Comprehensive Systematic and Meta-Analysis

Chellan Kumarasamy et al. Cells. .

Abstract

Head and Neck Cancer (HNC) is the sixth most common type of cancer across the globe, with more than 300,000 deaths each year, globally. However, there are currently no standardised molecular markers that assist in determining HNC prognosis. The literature for this systematic review and meta-analysis were sourced from multiple bibliographic databases. This review followed PRISMA guidelines. The Hazard Ratio (HR) was selected as the effect size metric to independently assess overall survival (OS), disease-free survival (DFS), and prognosis. Subgroup analysis was performed for individual highly represented miRNA. A total of 6843 patients across 50 studies were included in the systematic review and 34 studies were included in the meta-analysis. Studies across 12 countries were assessed, with China representing 36.7% of all included studies. The analysis of the survival endpoints of OS and DFS were conducted separately, with the overall pooled effect size (HR) for each being 1.825 (95% CI 1.527-2.181; p < 0.05) and 2.596 (95% CI 1.917-3.515; p < 0.05), respectively. Subgroup analysis was conducted for impact of miR-21, 200b, 155, 18a, 34c-5p, 125b, 20a and 375 on OS, and miR-21 and 34a on DFS. The pooled results were found to be statistically significant for both OS and DFS. The meta-analysis indicated that miRNA alterations can account for an 82.5% decrease in OS probability and a 159.6% decrease in DFS probability. These results indicate that miRNAs have potential clinical value as prognostic biomarkers in HNC, with miR-21, 125b, 34c-5p and 18a, in particular, showing great potential as prognostic molecular markers. Further large scale cohort studies focusing on these miRNAs are recommended to verify the clinical utility of these markers individually and/or in combination.

Keywords: head and neck cancer; meta-analysis; microRNAs; prognosis; systematic review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart describing search strategy.
Figure 2
Figure 2
Forest plots for the miRNAs associated with OS. (A) Upregulated miRNA; (B) Downregulated miRNA.
Figure 2
Figure 2
Forest plots for the miRNAs associated with OS. (A) Upregulated miRNA; (B) Downregulated miRNA.
Figure 3
Figure 3
Forest plot for the miRNAs associated with DFS.
Figure 4
Figure 4
Forest plot for miR-21 association with OS.
Figure 5
Figure 5
Forest plot for miR-200b association with OS.
Figure 6
Figure 6
Forest plot for miR-155 association with OS.
Figure 7
Figure 7
Forest plot for miR-18a association with OS.
Figure 8
Figure 8
Forest plot for miR-34c-5p association with OS.
Figure 9
Figure 9
Forest plot for miR-125b for association with OS.
Figure 10
Figure 10
Forest plot for miR-20a association with OS.
Figure 11
Figure 11
Forest plot for miR-375 association with OS.
Figure 12
Figure 12
Forest plot for miR-21 association with DFS.
Figure 13
Figure 13
Forest plot for miR-34a association with DFS.
Figure 14
Figure 14
Funnel plot for the studies prognostic of OS.
Figure 15
Figure 15
Funnel plot for the studies prognostic of DFS.
See this image and copyright information in PMC

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