Prognostic role of E2F1 gene expression in human cancer: a meta-analysis

Abstract

Objective: E2F1 has been confirmed to be highly expressed in a variety of cancers. To better understand the prognostic value of E2F1 in cancer patients, this study was conducted to comprehensively evaluate the prognostic value of E2F1 in cancer according to published data.

Method: PubMed, Web of Science and CNKI database were searched until May 31^th, 2022 by using key words to retrieve the published essays on the role of E2F1 expression in the prognostic value of cancer. The essays were identified according to the inclusion and exclusion criteria. The pooled result of hazard ratio and 95% confidence interval was calculated with Stata17.0 software.

Result: A total of 17 articles were included in this study involved in 4481 cancer patients. The pooled results showed that higher E2F1 expression was significantly correlated with unfavorable overall survival (HR = 1.10, I² = 95.3%, *P_{Heterogeneity} = 0.000) and disease-free survival (HR = 1.41, I² = 95.2%, *P_{Heterogeneity} = 0.000) of cancer patients. Such a significant association of was maintained subgroup of sample size of patients (> 150: for OS, HR = 1.77, and for DFS, HR = 0.91; or < 150: for OS, HR = 1.93, and for DFS, HR = 4.39), ethnicity (Asian: for OS, HR = 1.65, and for DFS, HR = 1.08; or not Asian: HR = 3.55, and for DFS, HR = 2.87), the data from database (clinical: for OS, HR = 1.24, and for DFS, HR = 1.40; or database: for OS, HR = 2.29, and for DFS, HR = 3.09), paper published year (after 2014: for OS, HR = 1.90;and for DFS,HR = 1.87; or before 2014: for OS, HR = 1.40, and for DFS, HR = 1.22); cancer type (female specific cancer: for OS, HR = 1.41, and for DFS, HR = 0.64; or non-gender specific cancers: for OS, HR = 2.00, and for DFS, HR = 2.95). In addition, according to the database data, we also found that higher E2F1 expression level would lead to worse prognosis of patients, and the results were consistent with the statistical analysis results in the paper.

Conclusion: E2F1 could be served as a prognostic biomarker in cancer patients and higher levels of in cancer patients could predict shorter overall survival and disease-free survival.

Keywords: Breast cancer; Cancer; Disease-free survival; E2F1; Gene expression; Meta-analysis; Overall survival; Prognosis.

Fig. 1

Flow diagram of the study selection process

Fig. 2

Forest plot of extracted HR for the association of E2F1 expression (*p < 0.05)

Fig. 3

Forest plot of extracted HR for the association of E2F1 expression with OS /DFS. A Forest plot of extracted HR for the association of E2F1 expression with OS (*p < 0.05)and (B) Forest plot of extracted HR for the association of E2F1 expression with DFS (*p < 0.05)

Fig. 4

Forest plots of the E2F1 according to subgroup. A Cancer type subgroup in OS group (p > 0.05). B Ethnicity subgroup in OS group (*p < 0.05). C Sources subgroup in OS group (p > 0.05). D Year subgroup in OS group (p > 0.05). E Case subgroup in OS group (p > 0.05). F Cancer type subgroup in DFS group (p > 0.05). G Ethnicity subgroup in DFS group (p > 0.05). H Sources subgroup in DFS group (p > 0.05). I Year subgroup in DFS group (p > 0.05). J Case subgroup in OS group (*p < 0.05)

Fig. 5

Sensitivity analysis

Fig. 6

Funnel plot for estimating the publication bias analysis. A OS group and (B) DFS group

Fig. 7

Begg’s tests and Egger’s tests for estimating the publication bias analysis. A Begg’s tests for OS group and (B) Egger’s test for OS group and (C) Begg’s tests for DFS group and (D) Egger’s test for DFS group

Fig. 8

Results from database showed that E2F1 is a valuable prognostic biomarker for cancers Survival prognosis curve (A) Bladder Urothelial Carcinoma, (B) Colon adenocarcinoma, (C) Lung adenocarcinoma; K–M plotter of E2F1 in (D) Lung cancer, (E) Ovarian cancer, (F) Breast cancer