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Shuai H, Duan X, Zhou JJ, Liu Y, Wu T. Effect of the TERT mutation on the prognosis of patients with urothelial carcinoma: a systematic review and meta-analysis. BMC Urol 2023; 23:177. [PMID: 37915019 PMCID: PMC10621162 DOI: 10.1186/s12894-023-01349-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Telomerase reverse transcriptase (TERT) mutation represents the most prevalent genetic mutation found in urothelial carcinoma (UC) and holds potential as a prognostic indicator for tumor outcomes. However, the association between TERT mutation and prognosis in UC patients remains poorly elucidated due to conflicting findings in existing literature. Therefore, this study aimed to investigate the effect of the TERT mutation on the survival of UC patients. METHODS We systematically searched the PubMed, Embase, and Cochrane Library databases for studies that investigated the relationship between the TERT mutation and the prognosis of UC patients. Endpoints included the 2-year and 5-year recurrence-free survival (RFS) and overall survival (OS). The Newcastle-Ottawa Scale (NOS) tool was used to assess the risk of bias in the included studies. Review Manager 5.3 was used for the meta-analysis. RESULTS Nine studies with a total of 1,552 patients were included in the analysis. Two studies were prospective, and seven were retrospective. The TERT promoter mutation was associated with a lower 2-year OS (relative risk [RR] = 0.92, 95% confidence interval [CI] 0.86-0.98; P = 0.007) and a lower 5-year OS (RR = 0.80, 95% CI 0.68-0.94; P = 0.008) compared with the TERT wild type. However, no significantly differences were found between two groups in terms of HR for OS (hazard ratio [HR] = 1.29, 95% CI 0.80-2.08; P = 0.29). Furthermore, we investigated the differences in RFS and disease-specific survival (DSS) between the two groups. CONCLUSION The TERT mutation increases the risk of death and decreases the survival time of UC patients. TERT may be a valuable marker with individual prognostic value.
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Grants
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 20SXQT0305, 18SXHZ0321 the City of Nanchong Strategic Cooperation with the Local Universities Foundation of Technology
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- 2020YJ0185, 2022NSFSC0804 the Application and Basic Research Program of the Sichuan Science and Technology Department
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- SWFZ21-C-98 the Primary Health Development Research Center of Sichuan Province Program
- S21061 the Medical Research Project of the Sichuan Medical Association
- S21061 the Medical Research Project of the Sichuan Medical Association
- S21061 the Medical Research Project of the Sichuan Medical Association
- S21061 the Medical Research Project of the Sichuan Medical Association
- S21061 the Medical Research Project of the Sichuan Medical Association
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Affiliation(s)
- Hui Shuai
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 57, Shunqing District, Nanchong, Sichuan, 637000, People's Republic of China
| | - Xi Duan
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Shunqing, Nanchong, Sichuan, 637000, People's Republic of China
| | - Jun-Jie Zhou
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 57, Shunqing District, Nanchong, Sichuan, 637000, People's Republic of China
| | - Yuan Liu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 57, Shunqing District, Nanchong, Sichuan, 637000, People's Republic of China
| | - Tao Wu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 57, Shunqing District, Nanchong, Sichuan, 637000, People's Republic of China.
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Wang K, Wang RL, Liu JJ, Zhou J, Li X, Hu WW, Jiang WJ, Hao NB. The prognostic significance of hTERT overexpression in cancers: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e11794. [PMID: 30170373 PMCID: PMC6392887 DOI: 10.1097/md.0000000000011794] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Human telomerase reverse transcriptase (hTERT) plays an important role in cancer progression. Recently, several clinical studies investigated how the overexpression of hTERT predicts the poor prognosis of solid tumors. However, the results were inconclusive, partly because of the small numbers of patients included. METHOD We systematically searched PubMed, Web of Science, and Embase to identify relevant studies until August 2017. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to evaluate the association of hTERT expression and survival outcomes. RESULTS A total of 27studies enrolling 2530 solid tumor patients were included in this meta-analysis. There were strong significant associations between hTERT overexpression and all endpoints: overall survival (OS) (HR = 1.50, 95% CI: 1.31-1.73, P = .00), disease-free survival (HR = 1.84, 95% CI: 1.38-2.46; P = .00), and recurrence-free survival (HR = 1.79, 95% CI: 1.07-2.99; P = .028). In the subgroup analysis, it was found that the overexpression of hTERT induced poor OS in lung cancer (HR = 1.51, 95% CI: 1.21-1.89; P = .00). CONCLUSION Our comprehensive systematic review concluded that the overexpression of hTERT was associated with poor survival in human solid tumors. hTERT may be a valuable predictive biomarker for prognosis.
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Affiliation(s)
- Kai Wang
- New Era Stoke Care and Research Institute
| | - Rui-Ling Wang
- Department of Gastroenterology, General Hospital of the PLA Rocket Force; Beijing, China
| | - Jian-Jun Liu
- Department of Gastroenterology, General Hospital of the PLA Rocket Force; Beijing, China
| | - Ji Zhou
- New Era Stoke Care and Research Institute
| | - Xue Li
- Department of Gastroenterology, General Hospital of the PLA Rocket Force; Beijing, China
| | - Wen-Wei Hu
- Department of Gastroenterology, General Hospital of the PLA Rocket Force; Beijing, China
| | | | - Ning-Bo Hao
- Department of Gastroenterology, General Hospital of the PLA Rocket Force; Beijing, China
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Guan GG, Wang WB, Lei BX, Wang QL, Wu L, Fu ZM, Zhou FX, Zhou YF. UBE2D3 is a positive prognostic factor and is negatively correlated with hTERT expression in esophageal cancer. Oncol Lett 2015; 9:1567-1574. [PMID: 25789002 PMCID: PMC4356423 DOI: 10.3892/ol.2015.2926] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/13/2015] [Indexed: 12/20/2022] Open
Abstract
Human telomerase reverse transcriptase (hTERT) is a critical factor in unlimited cell proliferation and immortalization, with numerous studies demonstrating that high expression of hTERT is a poor prognostic factor in various types of cancer. Ubiquitin-conjugating enzyme E2D 3 (UBE2D3) is a member of the E2 family, and participates in the ubiquitin proteasome pathway to regulate basic cellular activities, such as cell cycle control, the DNA damage response, apoptosis, and tumorigenesis. Our previous study initially determined that downregulation of UBE2D3 expression increases hTERT expression and cell proliferation, however, the association between the expression of these two proteins and their functions in cancer tissues remains unknown. Therefore, the protein expression levels of hTERT and UBE2D3 were evaluated in 150 esophageal cancer and 30 adjacent healthy tissue samples by performing immunohistochemical analysis. Concurrently, the clinicopathological data of the enrolled patients were obtained to allow correlation analysis. It was identified that the expression of hTERT in the esophageal cancer tissues was significantly higher compared with that of the adjacent tissues (P=0.015), however, the expression of UBE2D3 was significantly lower in esophageal cancer tissues than the adjacent tissues (P=0.001). Additionally, the study demonstrated that hTERT was significantly upregulated in poorly-differentiated, advanced tumor-node-metastasis (TNM) stage cancer tissues (P<0.05 for all), however, UBE2D3 expression was downregulated in poorly-differentiated, lymph node invaded cancer tissues and recurrent cases. It was also identified that traditional factors, including tumor location, T stage, lymph node status, TNM stage, and molecular factors of hTERT and UBE2D3, were significantly associated with overall survival time (P<0.05 for all). Furthermore, UBE2D3, lymph node status and tumor location were independent prognostic factors for esophageal cancer in multivariate analysis. Most notably, hTERT and UBE2D3 expression were negatively correlated with each other. In conclusion, the findings of the present study indicated that hTERT and UBE2D3 proteins appear to be involved in the development of esophageal cancer, that UBE2D3 may a positive prognostic factor for esophageal cancer, and that UBE2D3 and hTERT expression levels are inversely correlated.
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Affiliation(s)
- Ge Ge Guan
- Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Wen Bo Wang
- Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan University, Wuhan, Hubei 430071, P.R. China ; Department of Radiation and Medical Oncology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Bing Xin Lei
- Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Qiao Li Wang
- Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Lin Wu
- Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Zhen Ming Fu
- Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan University, Wuhan, Hubei 430071, P.R. China ; Department of Radiation and Medical Oncology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Fu Xiang Zhou
- Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan University, Wuhan, Hubei 430071, P.R. China ; Department of Radiation and Medical Oncology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Yun Feng Zhou
- Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan University, Wuhan, Hubei 430071, P.R. China ; Department of Radiation and Medical Oncology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
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Vinagre J, Pinto V, Celestino R, Reis M, Pópulo H, Boaventura P, Melo M, Catarino T, Lima J, Lopes JM, Máximo V, Sobrinho-Simões M, Soares P. Telomerase promoter mutations in cancer: an emerging molecular biomarker? Virchows Arch 2014; 465:119-33. [DOI: 10.1007/s00428-014-1608-4] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/19/2014] [Accepted: 06/16/2014] [Indexed: 12/16/2022]
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The CCND1 G870A polymorphism and susceptibility to bladder cancer. Tumour Biol 2013; 35:171-7. [PMID: 23893383 DOI: 10.1007/s13277-013-1021-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 07/12/2013] [Indexed: 10/26/2022] Open
Abstract
Published studies on the association between cyclin D1 (CCND1) G870A polymorphism and bladder cancer risk have yielded conflicting results. Thus, a systemic review and meta-analysis of published studies were performed to assess the possible association. All eligible studies of G870A polymorphism and bladder cancer risk were collected from the PubMed and the Cochrane Library. Statistical analyses were performed by Review Manager 5.0 and Stata 11.0. Significant association between G870A polymorphism and bladder cancer susceptibility was found under recessive model in overall population (OR = 1.21, 95% CI 1.01-1.45, P = 0.04). When stratifying for the race, our analysis suggested that CCND1 G870A was associated with bladder cancer risk in Asians when using homogeneous codominant (OR = 1.72, 95% CI 1.34-2.20, P < 0.0001), recessive (OR = 1.46, 95% CI 1.21-1.77, P < 0.0001), dominant (OR = 1.36, 95% CI 1.10-1.69, P = 0.004), and allelic models (OR = 1.30, 95% CI 1.15-1.47, P < 0.0001) to analyze the data. However, no significant associations were found in Caucasians. After stratifying the studies by control source, G870A polymorphism was significantly associated with bladder cancer risk under recessive model (OR = 1.31, 95% CI 1.03-1.67, P = 0.03) in hospital-based case-control studies, but not in population-based case-control studies. This meta-analysis suggested that G870A polymorphism most likely contributes to increased susceptibility to bladder cancer in the overall population, hospital-based case-control studies, and Asians.
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