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Accumulating studies reported the clinical value of derived neutrophil/lymphocyte ratio (dNLR) regarding the prediction of survival outcomes in digestive cancers, however, the prognostic significances of dNLR in these cancers were inconsistent. This study was carried out to clarify the relationship between circulating dNLR and prognosis in gastrointestinal (GI) cancers. Eligible publications were collected and extracted by searching Pubmed, Embase, Web of Science, and Google Scholar up to November 21, 2018. The prognostic impact of dNLR in subjects with GI cancers was assessed with the overall hazard ratios (HRs). A total of 26 studies with up to 13,945 participants were recruited. Our findings showed that peripheral blood dNLR before treatment could be a useful prognostic predictor in digestive cancers, an elevated dNLR indicated a shorter overall survival (OS) in GI tumors (HR, 1.44; 95% confidence interval [CI], 1.36-1.51). Furthermore, its significant prognostic value for OS was also confirmed in subgroup analyses stratified by disease type, publication year, type of research, detection method, geographic location, cut-off value, treatment, analysis type, follow-up time and disease stage. In addition, high dNLR was significantly associated with worse cancer-specific survival (HR, 1.25; 95% CI, 1.04-1.47) and inferior event-free survival (HR, 1.22; 95% CI, 1.11-1.33) in patients with digestive cancers. Our study showed elevated peripheral blood dNLR may indicate unfavorable outcomes in digestive cancer.

Background/Aims: Long noncoding RNA (lncRNA) cancer susceptibility candidate 2 (CASC2) is downregulated in various cancers and involved in both tumorigenesis and progression. The aim of this study was to assess the prognostic value of lncRNA CASC2 in cancer patients. Methods: We searched the Web of Science, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and the Wanfang database to identify studies evaluating the prognostic value of lncRNA CASC2 in cancer patients. Pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed-effects/random-effects models. Results: A total of eight studies were included. The combined results showed that lncRNA CASC2 was significantly associated with decreased overall survival (OS) (HR = 0.37, 95% CI, 0.27–0.46, P < 0.001). Subgroup analyses further indicated that low expression of lncRNA CASC2 predicted decreased OS in cancer patients. Additionally, low CASC2 expression levels in cancer tissues appeared to be correlated with advanced clinical staging (OR = 3.32, 95% CI, 2.29–4.80, P < 0.001). Conclusions: Low CASC2 expression appears to be predictive of poor OS and advanced tumor stage in multiple cancers. CASC2 expression may serve as unfavorable prognostic factor for clinical outcomes in cancer patients.

// Fang-Teng Liu 1, * , Hui Gao 1, * , Chang-Wen Wu 2, * and Zheng-Ming Zhu 1 1 Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, P.R. China 2 Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, P.R. China * These authors have contributed equally to this work Correspondence to: Zheng-ming Zhu, email: zzm8654@163.com Keywords: plasma fibrinogen, esophageal cancer, prognosis, clinicopathological feature, biomarker Received: May 07, 2017 Accepted: August 04, 2017 Published: October 10, 2017 ABSTRACT Background: Numerous studies have shown that plasma fibrinogen was linked to esophageal cancer (EC) risk. However, the clinical significance of plasma fibrinogen in EC patients remain unclear and need to be further clarified. Results: A total of 2865 patients with EC from 11 published studies were included in this meta-analysis. The prognostic and clinical relevance of plasma fibrinogen were evaluated in EC patients. Statistical significance of the pooled hazard ratio (HR) was found for overall survival (OS), disease free survival (DFS) and recurrence-free survival (RFS) in EC. Subgroup analyses for OS were also performed to confirm the prognostic value of plasma fibrinogen. Additionally, the overall results indicated that elevated plasma fibrinogen was significantly associated with tumor invasion, lymph node metastasis (LNM) and clinical stage. Materials and Methods: A comprehensive literature retrieval was performed in PubMed, Embase, Cochrane database, Web of science and Chinese National Knowledge Infrastructure (CNKI) and Wanfang databases to identify relevant studies published prior to April 15, 2017. Conclusions: Elevated plasma fibrinogen could be served as a promising biomarker for predicting a poor prognosis and unfavorable clinicopathologic features for EC.

// Fangteng Liu 1, * , Hui Gao 1, * , Siyu Li 2 , Xiaolin Ni 2 and Zhengming Zhu 1 1 Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, P. R. China 2 The Second Clinical Medical College of Nanchang University, Nanchang 330000, Jiangxi Province, P. R. China * These authors have contributed equally to this work Correspondence to: Zhengming Zhu, email: zzm8654@163.com Keywords: ZFAS1, long non-coding RNA, cancer, prognosis, biomarker Received: March 01, 2017 Accepted: May 31, 2017 Published: June 27, 2017 ABSTRACT Dysregulation of long non-coding RNA zinc finger antisense 1 (ZFAS1) has been reported in many types of cancers. We performed a synthetic analysis to clarify its prognostic significance as a cancer molecular-marker. Several databases (including PubMed, Web of Science, Embase together with Wanfang and China National Knowledge Internet database) were retrieved to identify ZFAS1-related articles. A total of eight articles were included in this meta-analysis. Hazard ratios (HR) and 95% confidence intervals (CI) were applied to assess the association between ZFAS1 expression level and overall survival (OS). Odds ratios (OR) were calculated with RevMan 5.3 software to determine the relationship between ZFAS1 expression and clinicopathologic features. The pooled results of the meta-analysis indicated that high ZFAS1 expression level was positively correlated with poor OS (HR = 1.87, 95% CI: 1.38-2.36, p< 0.001) in human solid cancers. The statistical significance was also observed in subgroup analysis stratified by the cancer type, analysis method, sample size and follow-up time. Furthermore, the elevated ZFAS1 expression was significantly related to positive lymph node metastasis (OR = 4.18, 95% CI: 2.70-6.48, p< 0.001). The present results suggest that ZFAS1 might be served as a novel promising biomarker for prognosis in Chinese patients with solid cancers.

// Fang-Teng Liu 1, 2, * , Qing Dong 2, 3, * , Hui Gao 4, * and Zheng-Ming Zhu 1 1 Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, P.R. China 2 Medical School of Nanchang University, Nanchang 330000, Jiangxi Province, P.R. China 3 The Third Radiotherapy Department, Tumor Hospital of Jiangxi Province, Nanchang 330029, Jiangxi Province, P.R. China 4 The Children’s Hospital of Zhejiang University School of Medicine, Hangzhou 310052, Zhejiang Province, P.R. China * These authors have contributed equally to this work Correspondence to: Zheng-Ming Zhu, email: zzm8654@163.com Keywords: UCA1, lncRNA, carcinoma, digestive system, prognosis Received: November 10, 2016 Accepted: February 28, 2017 Published: March 23, 2017 ABSTRACT Background: Urothelial Carcinoma Associated 1 (UCA1) was an originally identified lncRNA in bladder cancer. Previous studies have reported that UCA1 played a significant role in various types of cancer. This study aimed to clarify the prognostic value of UCA1 in digestive system cancers. Results: The meta-analysis of 15 studies were included, comprising 1441 patients with digestive system cancers. The pooled results of 14 studies indicated that high expression of UCA1 was significantly associated with poorer OS in patients with digestive system cancers (HR: 1.89, 95 % CI: 1.52–2.26). In addition, UCA1 could be as an independent prognostic factor for predicting OS of patients (HR: 1.85, 95 % CI: 1.45–2.25). The pooled results of 3 studies indicated a significant association between UCA1 and DFS in patients with digestive system cancers (HR = 2.50; 95 % CI = 1.30–3.69). Statistical significance was also observed in subgroup meta-analysis. Furthermore, the clinicopathological values of UCA1 were discussed in esophageal cancer, colorectal cancer and pancreatic cancer. Materials and methods: A comprehensive retrieval was performed to search studies evaluating the prognostic value of UCA1 in digestive system cancers. Many databases were involved, including PubMed, Web of Science, Embase and Chinese National Knowledge Infrastructure and Wanfang database. Quantitative meta-analysis was performed with standard statistical methods and the prognostic significance of UCA1 in digestive system cancers was qualified. Conclusions : Elevated level of UCA1 indicated the poor clinical outcome for patients with digestive system cancers. It may serve as a new biomarker related to prognosis in digestive system cancers.

Background/Aims: Many studies have reported that PVT1 played important roles in diverse cancer types. But the systematic analysis of PVT1 in gastrointestinal cancers has not been inspected. Thus, we aimed to investigate clinical value of the long noncoding RNA PVT1 (lncRNA) expression in digestive system cancers. Methods: Eligible studies were collected from a number of databases (PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure and Wanfang database). Pooled hazard ratio (HR) or odds ratio (OR) with 95 % confidence interval (95 % Cl) were applied to assess the clinical significance of PVT1. Results: Data from 15 articles were included with a total of 2585 patients. Elevated PVT1 expression were significantly related to poor overall survival (OS) [HR = 1.86, 95% CI (1.44, 2.28); p

Introduction Numerous studies have investigated the relationship between deregulated HOXB7 expression with the clinical outcome in patients with digestive stem cancers, HOXB7 has showed negative impacts but with varying levels. We aimed to comprehensively evaluate the prediction and prognostic value of HOXB7 in digestive stem cancers. Evidence acquisition Electronic databases updated to December 1st, 2016 were retrieved to collect relevant eligible studies to quantitatively explore the potential roles of HOXB7 as a prognostic indicator in digestive system cancers. Evidence synthesis A total of 9 studies (N.=1298) was included in this synthetical meta-analysis. The pooled hazard ratios suggested that high expression of HOXB7 protein was associated with poor prognosis of OS in patients with digestive system cancers (HR=1.97, 95% CI: 1.65-2.28, P=0.000), and HOXB7 protein could act as an independent prognostic factor for predicting OS of patients with digestive system cancers (HR=2.02, 95% CI: 1.69-2.36, P=0.000). Statistical significance was also observed in subgroup meta-analysis based on the cancer type, histology type, country, sample size and publication date. Furthermore, we examined the correlations between HOXB7 protein and clinicopathological features. It showed that altered expression of HOXB7 protein was correlated with tumor invasion (P=0.000), lymph node status (P=0.000), distant metastasis (P=0.001) and TNM stage (P=0.000). However, the expression of HOXB7 protein was not associated with age (P=0.64), gender (P=0.40) or levels of differentiation (P=0.19). Conclusions High expression of HOXB7 protein was associated with poor prognosis of patients with digestive system cancers, as well as clinicopathologic characteristics, including the tumor invasion, lymph node status, distant metastasis and TNM stage. The expression of HOXB7 protein was not associated with age, gender or levels of differentiation. HOXB7 protein expression level in tumor tissue might serve as a novel prognostic marker for digestive system cancers.

// Fang-teng Liu 1 , Hua Pan 1 , Guang-feng Xia 1 , Cheng Qiu 1 , Zheng-ming Zhu 1 1 Department of General Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, P. R. China Correspondence to: Zheng-ming Zhu, email: zzm8654@163.com Keywords: long noncoding RNA, H19, carcinoma, prognosis, meta-analysis Received: April 29, 2016 Accepted: October 17, 2016 Published: November 4, 2016 ABSTRACT Background: Many studies have reported that the expression level of lncRNA H19 was increased in various tumors. LncRNA H19 may play a significant role in cancer occurrence and development. An increased level of H19 was also associated with poor clinical outcomes of cancer patients. Results: 12 eligible studies were screened, with a total of 1437 cancer patients. From the results of meta-analysis, as for prognosis, the patients with high expression of lncRNA H19 were shorter in OS (HR=1.08, 95% CI: 1.05-1.12). Statistical significance was also showed in subgroup meta-analysis stratified by the cancer type, analysis type and sample size. In addition, the patients detected with high H19 expression may be poorer in DFS (HR=1.27; 95% CI = 0.97-1.56). As for clinicopathology, it showed that increased H19 was related to poor histological grades (OR=2.31, 95% CI: 1.12-4.75), positive lymph node metastasis (OR=2.29, 95 % CI: 1.21-4.34) and advanced clinical stage (OR=4.83, 95% CI: 3.16-7.39). Materials and Methods: Eligible studies were collected by retrieving keywords in PubMed, Web of Science, Embase, CNKI and Wanfang database, from 1966 to April 23, 2016. This quantitative meta-analysis was performed with Stata SE12.0 and RevMan5.3 software. It aimed to explore the association between H19 expression level and prognosis and clinicopathology. Conclusions: LncRNA-H19 may be a novel molecular marker for predicting solid tumors. It can also be a predictive factor of clinicopathological features in various cancers. Further studies are needed to verify the clinical utility of H19 in human cancers.

// Fangteng Liu 1, * , Hui Gao 2, * , Yang Zhao 3, * and Zhengming Zhu 1 1 Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, P. R. China 2 The Children’s Hospital of Zhejiang University School of Medicine, Hangzhou 310052, Zhejiang Province, P. R. China 3 Nanchang University School of Public Health, Nanchang 330031, Jiangxi Province, P. R. China * These authors have contributed equally to this work Correspondence to: Zhengming Zhu, email: zzm8654@163.com Keywords: TBL1XR1, cancer, prognosis, clinicopathology, biomarker Received: March 14, 2017 Accepted: May 15, 2017 Published: June 27, 2017 ABSTRACT Transducin (β)-like 1 X-linked receptor 1(TBL1XR1) has been reported to be overexpressed in various human cancers, as well as contributing to carcinogenesis and progression. This synthetic analysis was performed to assess whether TBL1XR1 protein could act as a potential prognostic molecular marker for human cancers. Several online databases (PubMed, Web of Science, Embase together with Wanfang and China National Knowledge Internet database) were retrieved to identify TBL1XR1-related publications. A total of ten studies with 1837 cancer patients were included in this meta-analysis. Hazard ratios (HR) with 95% confidence intervals (CI) were applied to assess the association between TBL1XR1 expression and cancer prognosis. Odds ratios (OR) were calculated to determine the relationship between TBL1XR1 expression and clinicopathological characteristics. The overall results revealed that the overexpression of TBL1XR1 was correlated with poorer overall survival (OS) (HR: 1.77, 95% CI: 1.49–2.06, p < 0.001) and worse disease-free survival (DFS) (HR: 1.51, 95% CI: 1.19–1.84, p < 0.001) in human solid cancers. Statistical significance for OS was also found in subgroup analysis stratified by the cancer type, analysis method and follow-up time. Furthermore, elevated TBL1XR1 was associated with unfavorable clinicopathological characteristics including tumor size, depth of invasion, lymph node metastasis and TNM stage. Our meta-analysis suggested that TBL1XR1 might be served as a novel and promising biomarker to predict prognosis and clinicopathologic characteristic for cancer patients.

// Yang-xi Ou 1, * , Fang-teng Liu 1, 2, * , Fang-ying Chen 3 and Zheng-ming Zhu 1 1 Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, P. R. China 2 Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, P. R. China 3 The Health Centers of Fengzhou Town, Quanzhou 36200, Fujian Province, P. R. China * These authors have contributed equally to this work Correspondence to: Zhengming Zhu, email: zzm8654@163.com Keywords: Flotillin-1, carcinoma, prognosis, meta-analysis Received: December 21, 2016 Accepted: March 16, 2017 Published: April 13, 2017 ABSTRACT Background: In numerous studies, Flotillin-1 was reported to be involved in tumor progression, indicating prognosis in various types of cancer. However, the results were inconsistent. Results: A total of 2473 patients from 13 articles were included. The results indicated that: (1) Patients detected with high expression level of Flotillin-1 protein had a significantly shorter OS (HR =1.64; 95%CI: 1.39-1.88), statistical significance was also observed in subgroup meta-analyses stratified by the cancer type, nationality, detecting method, cutoff value, analysis type, sample size and publication date. (2) Patients with high Flotillin-1 protein expression level had a poorer DFS (HR = 2.49; 95%CI: 1.64-3.35), a worse RFS(HR = 3.26; 95%CI: 1.10-5.43) and a potential shorter PFS(HR = 1.84; 95%CI: 0.81-2.87). (3) The pooled odds ratios (ORs) showed that increased Flotillin-1 level was also related to lymph node metastasis (OR =6.30; 95% CI: 3.15-12.59), distant metastasis (OR =6.02; 95% CI: 1.50-24.06) and more advanced TNM stage (OR =4.69; 95% CI: 2.74-8.03). Materials and methods: A comprehensive retrieval was performed in multiple databases, including PubMed, Embase, Web of Science and CNKI. The relevant articles were screened for investigating the association between increased Flotillin-1 expression level and prognosis. Additionally, clinicopathological features data was also extracted from these studies. Conclusions: High expression level of Flotillin-1 protein was correlated with poorer clinical outcome. It might serve as a prognostic biomarker and a potential predictive factor of clinicopathology in various tumors. Further well-designed clinical studies should be performed to verify the clinical utility of Flotillin-1 in human solid tumors.

Fang-teng Liu,1,* Qi-zhen Xue,2,* Pei-qian Zhu,1 Hong-liang Luo,1 Yi Zhang,1 Tengfei Hao1 1Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 2Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, People’s Republic of China *These authors contributed equally to this paper Abstract: A number of studies have demonstrated that the expression level of actin filament-associated protein 1 antisense RNA 1 (AFAP1-AS1) was upregulated in various cancers. High expression of AFAP1-AS1 is associated with an increased risk of metastasis and a poor prognosis in cancer patients. The electronic search was conducted in PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang database. We collected relevant articles to explore the association between the expression levels of AFAP1-AS1 and lymph node metastasis, distant metastasis, overall survival, relapse-free survival, and progression-free survival. A total of 1,017 patients from eight studies were finally included. The results showed that cancer patients with high AFAP1-AS1 expression suffered an increased risk of developing lymph node metastasis (odds ratio =3.19, 95% confidence interval [CI]: 2.11–4.83, P

Fang-teng Liu, Yang-xi Ou, Guan-ping Zhang, Cheng Qiu, Hong-liang Luo, Pei-qian ZhuDepartment of Gastrointestinal Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People’s Republic of ChinaAbstract: Numerous studies on carcinoma have revealed that the expression level of HOXB7 in cancerous tissues was significantly higher than that in noncancerous tissues. Elevated expression of HOXB7 is associated with the susceptibility to lymph node metastasis and distant metastasis in various tumors. In this study, a meta-analysis was performed to involve majority of relevant articles and explore the association of HOXB7 expression level with metastasis in cancer patients. Literature retrieval was conducted by searching in a number of electronic databases (upto December 1, 2015). The meta-analysis was conducted with RevMan 5.3 software and Stata SE12.0. A total of 1,532 patients with carcinoma from 14 studies were included in analysis. The results of meta-analysis demonstrated that lymph node metastasis was observed more frequently in the patients group with high expression level of HOXB7 than in the patients group with low expression level of HOXB7 (odds ratio =2.17, 95% CI: 1.74–2.71, P