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. 2019 Dec;7(23):785.
doi: 10.21037/atm.2019.11.32.

Relationship between NAMPT/PBEF/visfatin and prognosis of patients with malignant tumors: a systematic review and meta-analysis

Chengjian Ji  1 , Rong Cong  1 , Yi Wang  1   2 , Yamin Wang  1 , Qijie Zhang  1 , Xiang Zhou  1 , Qianwei Xing  2 , Ninghong Song  1
Affiliations

Relationship between NAMPT/PBEF/visfatin and prognosis of patients with malignant tumors: a systematic review and meta-analysis

Chengjian Ji et al. Ann Transl Med. 2019 Dec.

Abstract

Background: Nicotinamide phosphoribosyltransferase (NAMPT), also known as pre-B-cell colony-enhancing factor (PBEF) or visfatin, has been reported to be a crucial factor involved in tumor metabolism, angiogenesis and cell apoptosis. However, its definite roles in patients with malignant cancer remain unclear.

Methods: Three online databases PubMed, Embase and Web of Science were looked through comprehensively for eligible articles, published before November, 2018. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) of overall survival (OS) or disease-free survival time or recurrence-free survival (DFS/RFS) were calculated to determine the associations between NAMPT expression and cancer prognosis.

Results: A total of ten eligible studies were finally enrolled for this analysis. Our results indicated that elevated NAMPT expression was associated with poor OS in breast cancer by both univariate and multivariate analysis (pooled HR =3.23, 95% CI: 1.93-5.41, I2=21.1%, P=0.283; pooled HR =3.34, 95% CI: 2.13-5.22, I2=0.0%, P=0.791; respectively) and in gastric cancer by univariate analysis (pooled HR =2.47, 95% CI: 1.07-5.73, I2=91.1%, P=0.001). Moreover, high expression of NAMPT was also related to poor DFS/RFS in breast cancer by univariate and multivariate analysis (pooled HR =3.85, 95% CI: 2.59-5.71, I2=0.0%, P=0.700; pooled HR =3.43, 95% CI: 2.36-4.99, I2=0.0%, P=0.737; separately). Similar results could be found in urothelial carcinoma (pooled HR =3.14, 95% CI: 1.73-5.71, I2=47.8%, P=0.166; pooled HR =3.06, 95% CI: 1.57-5.98, I2=0.0%, P=0.860). Besides, the translational level of NAMPT was also validated by UALCAN and the Human Protein Atlas database [immunohistochemistry (IHC)].

Conclusions: Our results shed light on that NAMPT might be an oncogenic factor in breast cancer, gastric cancer and urothelial carcinoma.

Keywords: Nicotinamide phosphoribosyltransferase (NAMPT); cancer; meta-analysis; pre-B-cell colony-enhancing factor (PBEF); visfatin.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Forest plots of OS in association with NAMPT/PBEF/visfatin expression in various cancers based on univariate analysis. (A) The overall group; (B) the subgroup analysis of detected samples; (C) the subgroup analysis of cancer types. HR, hazard ratio; CI, confidence interval; OS, overall survival; NAMPT, nicotinamide phosphoribosyltransferase; PBEF, pre-B-cell colony-enhancing factor.
Figure 2
Figure 2
Forest plots of OS in association with NAMPT/PBEF/visfatin expression in various cancers based on multivariate analysis. (A) The overall group; (B) the subgroup analysis of detected samples; (C) the subgroup analysis of cancer types. HR, hazard ratio; CI, confidence interval; OS, overall survival; NAMPT, nicotinamide phosphoribosyltransferase; PBEF, pre-B-cell colony-enhancing factor.
Figure 3
Figure 3
Forest plots of DFS/RFS in association with NAMPT/PBEF/visfatin expression in various cancers based on univariate analysis. (A) The overall group; (B) the subgroup analysis of detected samples; (C) the subgroup analysis of cancer types. HR, hazard ratio; CI, confidence interval; DFS, disease-free survival; RFS, recurrence-free survival; NAMPT, nicotinamide phosphoribosyltransferase; PBEF, pre-B-cell colony-enhancing factor.
Figure 4
Figure 4
Forest plots of DFS/RFS in association with NAMPT/PBEF/visfatin expression in various cancers based on multivariate analysis. (A) The overall group; (B) the subgroup analysis of detected samples; (C) the subgroup analysis of cancer types. HR, hazard ratio; CI, confidence interval; DFS, disease-free survival; RFS, recurrence-free survival; NAMPT, nicotinamide phosphoribosyltransferase; PBEF, pre-B-cell colony-enhancing factor.
Figure 5
Figure 5
Boxplots of NAMPT/PBEF/vifatin expression level based on UALCAN. (A,B,C,D,E) Breast cancer (BRCA); (F,G,H,I,J) bladder cancer (BLCA); (K,L,M,N,O,P) stomach adenocarcinoma((STAD). *, P<0.05. NAMPT, nicotinamide phosphoribosyltransferase; TCGA, The Cancer Genome Atlas; PBEF, pre-B-cell colony-enhancing factor.
Figure 6
Figure 6
Validation of NAMPT/PBEF/visfatin in the translational level by The Human Protein Atlas database (IHC). The translational expression level of NAMPT/PBEF/visfatin was positively correlated with disease status as they were upregulated in cancer samples. (A) Breast cancer sample (40×); (B) bladder cancer sample (40×); (C) stomach cancer sample (40×). NAMPT, nicotinamide phosphoribosyltransferase; PBEF, pre-B-cell colony-enhancing factor; IHC, immunohistochemistry.
Figure S1
Figure S1
Flow diagram of study selection process.
Figure S2
Figure S2
Sensitivity analysis of each included study. (A) OS for individual studies by multivariate analysis; (B) DFS/RFS for individual studies by multivariate analysis. CI, confidence interval; OS, overall survival; DFS, disease-free survival; RFS, recurrence-free survival.
Figure S3
Figure S3
Begg’s funnel plots of the publication bias. (A) OS for individual studies by multivariate analysis; (B) DFS/RFS for individual studies by multivariate analysis. OS, overall survival; DFS, disease-free survival; RFS, recurrence-free survival.
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