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. 2025 May 23:15:1579013.
doi: 10.3389/fonc.2025.1579013. eCollection 2025.

Ferroptosis-related lncRNAs as prognostic biomarkers in renal cell carcinoma: a systematic review and meta-analysis

Jia-Feng Lin  1 , Zhi-Huang Wu  1 , Min-Jie Zhang  1 , Jian-Bin Luo  1 , Guo-Qiang Chen  1
Affiliations

Ferroptosis-related lncRNAs as prognostic biomarkers in renal cell carcinoma: a systematic review and meta-analysis

Jia-Feng Lin et al. Front Oncol. .

Abstract

Background: Abundant evidences have indicated that long non-coding RNAs (lncRNAs) can be used to evaluate the prognosis of patients with renal cell carcinoma (RCC), and the purpose of this study was to evaluate the association between ferroptosis-related lncRNAs (FRLs) and the prognosis of patients with RCC by means of a meta-analysis.

Materials and methods: All studies assessing the prognosis of patients with FRLs and RCC were collected up to 31 October 2024 by searching databases such as PubMed, Web of Science, Embase, Scopus and Cochrane Library. Pooled analyses were performed on the collected data, including metrics such as gender, age, risk score, tumor stage, and tumor grade. Hazard ratio (HR) and 95% confidence intervals (CI) were employed to assess the outcome metrics. To evaluate the heterogeneity among studies, the I² statistic and Q test were utilized. P < 0.05 was regarded as statistically significant. All data analyses were conducted by Stata 17.0 software and Review Manager 5.4.1.

Results: 19 literatures involving 5974 RCC patients were included in this study. The meta-analysis outcomes indicate that there was no significant correlation between FRLs and the gender of RCC patients (HR = 0.93, 95% CI = 0.85 - 1.03, P = 0.17). However, FRLs were associated with patient age (HR = 1.03, 95% CI = 1.03 - 1.04, P < 0.00001), risk score (HR = 1.05, 95% CI = 1.03 - 1.06, P < 0.00001), tumor grade (HR = 1.46, 95% CI = 1.28 - 1.67, P < 0.00001) and tumor stage (HR = 1.85, 95% CI = 1.68-2.03, P < 0.00001) were significantly correlated. In tumor staging, FRLs were significantly correlated with N-stage (HR = 1.51, 95% CI = 1.10 - 2.08, P = 0.01) and M-stage (HR = 1.80, 95% CI = 1.21 - 2.68, P = 0.004) in patients with RCC, but not significantly correlated with T-stage in patients (HR = 1.34, 95% CI = 0.86 - 2.09, P = 0.19).

Conclusion: The findings of this study indicate that the abnormal expression of FRLs in RCC is obviously associated with the prognosis of patients, and that FRLs can be used as a new tumor marker to predict the prognosis of RCC patients with high accuracy.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024610803, identifier CRD42024610803.

Keywords: ferroptosis; lncRNAs; meta-analysis; prognosis; renal cell carcinoma.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the screening process for the included studies.
Figure 2
Figure 2
Forest plot of the relationship between FRLs and age.
Figure 3
Figure 3
Forest plot of the relationship between FRLs and gender.
Figure 4
Figure 4
Forest plot of the relationship between FRLs and risk scores.
Figure 5
Figure 5
Forest plot of subgroup analyses on the correlation between FRLs and risk scores.
Figure 6
Figure 6
Forest plot of the relationship between FRLs and tumor grade.
Figure 7
Figure 7
Forest plot of the relationship between FRLs and tumor stage.
Figure 8
Figure 8
Forest plot of subgroup analyses on the correlation between FRLs and tumor stage.
Figure 9
Figure 9
Forest plot of the relationship between FRLs and T-stage.
Figure 10
Figure 10
Forest plot of the relationship between FRLs and N-stage.
Figure 11
Figure 11
Forest plot of the relationship between FRLs and M-stage.
Figure 12
Figure 12
Sensitivity analysis based on tumor stage.
Figure 13
Figure 13
Funnel plot based on tumor stage.
Figure 14
Figure 14
Plot of egger's test.
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