LncRNA ZEB1-AS1 expression in cancer prognosis: Review and meta-analysis

Backgrounds: Several studies have explored the prognostic value of long non-coding RNA ZEB1 antisense RNA 1 (lncRNA ZEB1-AS1) in various types of cancer. However, the role of lncRNA ZEB1-AS1 in cancer prognosis remains unclear. This study aimed to summarize the prognostic value of lncRNA ZEB1-AS1 in cancer. Methods: PubMed, Web of Science, Embase and Cochrane Library were thoroughly searched. All relevant studies satisfying the inclusion criteria were enrolled. The endpoints used in this study included overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS) and various clinical parameters. Results: 11 studies containing 891 cancer patients were finally included into this study. The results showed that, compared to the patients with low expression of lncRNA ZEB1-AS1, the patients with high ZEB1-AS1 expression tended to have shorter OS (HR = 1.59, 95%CI = 1.41-1.80, P < 0.01), DFS (HR = 2.70, 95%CI = 1.38-5.27, P < 0.01) and RFS (HR = 1.82, 95%CI = 1.37-2.42, P < 0.01). In addition, compared to patients with low ZEB1-AS1 expression, the patients with high ZEB1-AS1 expression were obviously associated with worse differentiation (P < 0.01), deeper invasion (P < 0.01), a more advanced clinical stage (P < 0.01), earlier organ metastasis (P < 0.01) and earlier lymph node metastasis (P < 0.01). Conclusions: High expression of lncRNA ZEB1-AS1 was an unfavorable predictor of cancer prognosis in terms of OS, DFS, RFS, tumor differentiation, depth of invasion, clinical stage, organ metastasis and lymph node metastasis. Therefore, the expression of lncRNA ZEB1-AS1 might be used as a promising prognostic biomarker for cancer.