Long non-coding RNAs function as novel predictors and targets of non-small cell lung cancer: a systematic review and meta-analysis

// Yanlu Xiong 1, * , Tao Wang 1, * , Mingxing Wang 1 , Jinbo Zhao 1 , Xiaofei Li 1 , Zhipei Zhang 1 , Yongsheng Zhou 3 , Jiabao Liu 3 , Lintao Jia 2 and Yong Han 1 1 Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China 2 State Key Laboratory of Cancer Biology, Department of Biochemistry and Molecular Biology, Fourth Military Medical University, Xi'an, China 3 Department of Neurobiology and Collaborative Innovation Center for Brain Science, School of Basic Medicine, Fourth Military Medical University, Xi'an, China * These authors contributed equally to this work Correspondence to: Yong Han, email: hanyong_td@163.com Lintao Jia, email: jialth@fmmu.edu.cn Keywords: lncRNA; NSCLC; biomarker; prognosis; malignancy Received: July 13, 2017 Accepted: November 14, 2017 Published: January 04, 2018 ABSTRACT Objectives: Non-small cell lung cancer (NSCLC) is associated with high morbidity and mortality, leading the understanding the pathogenesis paramount. Recent studies suggest that long non-coding RNAs (lncRNAs) play an important role in NSCLC. We conducted a systematic review to examine the relationship between lncRNAs and NSCLC. Materials and Methods: We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate overall survival (OS), and odds ratios (ORs) and 95% CIs to assess clinicopathological parameters. Also, pooled sensitivity and specificity values were used to measure the diagnostic value of lncRNAs for NSCLC. Finally, we summarized the molecular mechanisms underlying the activity of lncRNAs in NSCLC. Results: We found that high expression of oncogenic lncRNAs was associated with a poor prognosis (OS: HR, 1.18; 95% CI, 1.14–1.22) and poor clinicopathological characteristics (tumor size: OR, 2.74 or 2.04; 95% CI, 1.66–4.52 or 1.09–3.79 based on the two classification criterias; lymph node metastasis: OR, 3.30; 95% Cl, 2.42–4.49), Also, high expression of tumor-suppressor lncRNAs was correlated with longer survival times (OS: HR, 0.54; 95% CI, 0.44–0.66) and improved clinical characteristics (tumor size: OR, 0.33 or 0.28; 95% CI, 0.14–0.75 or 0.18–0.45; lymph node metastasis: OR, 0.37; 95% Cl, 0.26–0.52). Furthermore, we found that lncRNAs could be used as serum biomarkers of NSCLC (sensitivity: 0.81; 95% CI, 0.72–0.87; specificity: 0.83; 95% CI, 0.73–0.90). Finally, lncRNAs regulated expression of key proteins, thereby mediating development of a malignant phenotype. Conclusions: lncRNAs have significant clinical value in NSCLC and could function as novel predictors of disease and/or as therapeutic targets.