The Impact of High lncRNA Expression on Clinicopathological Characteristics and Prognosis of Endometrial Cancer Patients: A Meta‐Analysis

TL;DR

High levels of long non-coding RNA in endometrial cancer are linked to worse outcomes and could help predict prognosis.

Contribution

This meta-analysis provides evidence that elevated lncRNA expression is a negative prognostic factor in endometrial cancer.

Findings

High lncRNA expression correlates with advanced cancer stages and worse histological grades.

Patients with high lncRNA levels have lower five-year survival and progression-free survival rates.

Upregulated lncRNAs are linked to increased metastasis and lymph node involvement in endometrial cancer.

Abstract

A growing number of systematic bioinformatics analyses were conducted to investigate the mechanism of interaction between long non‐coding RNA (lncRNA) and endometrial carcinoma (EC) to predict the prognosis. However, there is no evidence‐based evidence that abnormal lncRNA expression is strongly associated with the pathological characteristics and prognosis of EC patients. In this meta‐analysis, we systematically evaluated the relationship between upregulated lncRNA expression levels and clinicopathological features, five‐year survival rate, and progression‐free survival (PFS).

A systematic search was performed across seven reputable databases, namely the China National Knowledge Infrastructure, Wanfang, Wipu, PubMed, Web of Science, Cochrane Library, and Embase, encompassing the period from the inception of each database until November 27, 2022. Heterogeneity among the studies was assessed through the application of Cochran's Q and I
2 statistics. All statistical analyses were conducted using Stata 14.0 software.

This study encompassed 30 clinical studies, involving a total of 2469 EC patients, and examined the expression of 24 lncRNAs, which were upregulated in EC samples. EC patients with higher expression of lncRNAs showed a later FIGO stage (OR = 1.94, 95% CI: 1.29 ~ 2.91), a poorer histological grade (OR = 3.40, 95% CI: 2.51 ~ 4.60), earlier deep myometrial invasion (OR = 2.57, 95% CI: 1.94 ~ 3.41), a higher likelihood of lymphatic vascular space infiltration (OR = 2.86, 95% CI: 1.15 ~ 7.14), an increased propensity for lymph node metastasis (OR = 2.89, 95% CI: 1.82 ~ 4.60), and a greater likelihood of distant metastasis (OR = 2.39, 95% CI: 1.33 ~ 4.30). All of these were statistically significant (p < 0.05). Furthermore, EC patients with a higher expression level of lncRNAs were significantly associated with five‐year survival (p < 0.05) and PFS (p < 0.05).

High expression levels of upregulated lncRNAs in EC patients are associated with unfavorable clinicopathological features, a poor five‐year survival rate, and PFS. It serves as a detrimental prognostic factor and might be a biomarker and therapeutic target for EC.

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