Prognostic role of long noncoding RNA ZFAS1 in cancer patients: a systematic review and meta-analysis

Long noncoding RNA ZFAS1 has been identified as a crucial role in the tumorigenesis of malignant tumors. Numerous studies reported that the expression levels of ZFAS1 in tumor tissues were dramatically higher than that in adjacent normal tissues. We conducted a meta-analysis to investigate the correlation between ZFAS1 expression and clinical outcomes of cancer patients. The databases of PubMed, EMBASE, Web of Science, Cochrane Library, CNKI and WanFang were retrieved for eligible studies. A total of 841 patients from 9 studies were eventually included. Our results demonstrated that increased ZFAS1 expression was significantly associated with poor OS in cancer patients (HR = 2.13, 95% CI = 1.71-2.65, P < 0.001). Patients with high ZFAS1 expression presented shorter RFS than those with low ZFAS1 expression (HR = 2.00, 95% CI = 1.45-2.77, P < 0.001). The clinicopathological parameters analysis demonstrated that increased ZFAS1 expression was significantly associated with vascular invasion (OR = 2.26, 95% CI = 1.36-3.78, P = 0.002), lymph node metastasis (OR = 2.98, 95% CI = 2.12-4.19, P < 0.001) and advanced TNM stage (OR = 3.00, 95% CI = 2.18-4.12, P < 0.001). In conclusion, lncRNA ZFAS1 might serve as a prognostic biomarker for cancer patients and increased ZFAS1 expression may be closely related to advanced characteristics of cancer.