Prognostic Value of Circular RNA ciRS-7 in Various Cancers: A PRISMA-Compliant Meta-Analysis

Non-coding RNAs and gastrointestinal cancers prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies

Aim

Provide an overview and a systematic evaluation of the evidence quality on the association between non-coding RNAs (ncRNAs) and prognosis value for gastrointestinal cancers (GICs).

Methods

We searched the literature from three electronic databases: Pubmed, Embase, and Web of science, then carefully screened and extracted the primary information and results from the included articles. We use A measurable systematic review and meta-analysis evaluation tool (AMSTAR2) to evaluate the quality of methodology and then use the Grading of Recommendations Assessment 2, Development and Evaluation guideline (GRADE) make sure the reliability of the meta-analysis.

Results

Overall, 182 meta-analyses from 58 studies were included in this study. Most of these studies are of low or very low quality. Using the scoring tool, we found that only two meta-analyses were rated as high reliability, and 17 meta-analyses were rated as medium reliability.

Conclusions

Although ncRNA has good prognostic value in some studies, only a tiny amount of evidence is highly credible at present. More research is needed in the future.

PROSPERO registration number

CRD42022382296.

Investigation of the clinicopathological and prognostic role of circMTO1 in multiple cancers

OBJECTIVE

To observe the prognostic value of circular RNA mitochondrial tRNA translation optimization 1 (circMTO1) in human tumors.

METHODS

We searched multiple databases for related reports published before November 01, 2021. The OR/HR and 95% CI were extracted to explore the correlation between circMTO1 expression and clinicopathological features in various cancers. The stability of the results from meta-analysis was estimated via sensitivity analysis. We adopted Begg's funnel plots and Egger's test to appraise the potential bias of publication. Subgroup analysis for overall survival (OS) were also performed.

RESULTS

11 studies containing 1383 patients and 4 articles including 536 patients were enrolled. We found that low expression status of circMTO1 was significantly related to big tumor size (OR=2.11, 95% CI: 1.26-3.56, P<0.05), poor differentiation tumors (OR=2.09, 95% CI: 1.46-2.98, P<0.05), OS (HR=2.02, 95% CI: 1.63-2.50, P<0.05), disease-free survival (DFS) (HR=1.83, 95% CI: 1.27-2.56, P<0.05) of cancers. Subgroup analysis indicated that low expression status of circMTO1 was correlated with OS, regardless of analysis method, cut-off value, case number and NOS score.

CONCLUSIONS

The low expression of circMTO1 may predict big tumor size, poor differentiation and worse outcome of cancer, presenting that circMTO1 may be a useful biomarker for prognosis of tumors.

Noncoding RNome as Enabling Biomarkers for Precision Health

Noncoding RNAs (ncRNAs), in the form of structural, catalytic or regulatory RNAs, have emerged to be critical effectors of many biological processes. With the advent of new technologies, we have begun to appreciate how intracellular and circulatory ncRNAs elegantly choreograph the regulation of gene expression and protein function(s) in the cell. Armed with this knowledge, the clinical utility of ncRNAs as biomarkers has been recently tested in a wide range of human diseases. In this review, we examine how critical factors govern the success of interrogating ncRNA biomarker expression in liquid biopsies and tissues to enhance our current clinical management of human diseases, particularly in the context of cancer. We also discuss strategies to overcome key challenges that preclude ncRNAs from becoming standard-of-care clinical biomarkers, including sample pre-analytics standardization, data cross-validation with closer attention to discordant findings, as well as correlation with clinical outcomes. Although harnessing multi-modal information from disease-associated noncoding RNome (ncRNome) in biofluids or in tissues using artificial intelligence or machine learning is at the nascent stage, it will undoubtedly fuel the community adoption of precision population health.

Prognostic Significance of CircRNAs Expression in Oral Squamous Cell Carcinoma

OBJECTIVE

This systematic review was aimed to comprehensively evaluate the clinicopathological and prognostic value of dysregulated expression of circRNAs in OSCC.

MATERIALS AND METHODS

The research was carried out by searching mainstream electronic databases including PubMed, Embase, Web of Science, Scopus, LILACS and Cochrane Library to collect relevant studies on prognostic role of circRNAs in OSCC. Pooled hazard ratios (HRs) and odds ratios(ORs) with 95% confidence intervals(CIs) were calculated to assess the association between circRNAs expression, overall survival(OS), disease/recurrence/progression survival(DFS/RFS/PFS) and clinical parameters.

RESULTS

This research included 1813 patients from 26 selected articles. The pooled HR values(95% CIs) in OS were 2.38(1.92-2.93) for oncogenic circRNAs and 0.43(0.28-0.66) for tumor-suppressor circRNAs respectively, in DFS/RFS/PFS were 2.34(1.73-3.17). The meta-analysis on clinicopathology features showed higher level of oncogenic circRNAs is related to advanced TNM stage and tumor stage, worse histological differentiation, lymph node and distant metastasis, while enforced expression of tumor-suppressor circRNAs is related to inferior TNM stage tumor stage and lymphatic metastasis.

CONCLUSION

Our meta-analysis implies that circRNAs may be candidate biomarkers for the prognosis and clinicopathology of OSCC.

Biogenesis, functions, and clinical implications of circular RNAs in non-small cell lung cancer

Lung cancer (LC) is the leading cause of cancer-related deaths worldwide, with high morbidity and mortality. Non-small cell lung cancer (NSCLC) is a major pathological type of LC and accounts for more than 80% of all cases. Circular RNAs (circRNAs) are a large class of non-coding RNAs (ncRNAs) with covalently closed-loop structures, a high abundance, and tissue-specific expression patterns. They participate in various pathophysiological processes by regulating complex gene networks involved in proliferation, apoptosis, migration, and epithelial-to-mesenchymal transition (EMT), as well as metastasis. A growing number of studies have revealed that the dysregulation of circRNAs contributes to many aspects of cancer progression, such as its occurrence, metastasis, and recurrence, suggesting their great potential as efficient and specific biomarkers in the diagnosis, prognosis, and therapeutic targeting of NSCLC. In this review, we systematically elucidate the characteristics, biogenesis, and functions of circRNAs and focus on their molecular mechanisms in NSCLC progression. Moreover, we highlight their clinical implications in NSCLC treatment.

The Use of circRNAs as Biomarkers of Cancer

CircRNAs are a subclass of lncRNAs that have been found to be abundantly present in a wide range of species, including humans. CircRNAs are generally produced by a noncanonical splicing event called backsplicing that is dependent on the canonical splicing machinery, giving rise to circRNAs classified into three main categories: exonic circRNA, circular intronic RNA, and exon-intron circular RNA. Notably, circRNAs possess functional importance and display their functions through different mechanisms of action including sponging miRNAs, or even being translated into functional proteins. In addition, circRNAs also have great potential as biomarkers, particularly in cancer, thanks to their high stability, tissue type and developmental stage specificity, and their presence in biological fluids, which make them promising candidates as noninvasive biomarkers. In this chapter, we describe the most commonly used techniques for the study of circRNAs as cancer biomarkers, including high-throughput techniques such as RNA-Seq and microarrays, and other methods to analyze the presence of specific circRNAs in patient samples.

Insights into the Evolving Roles of Circular RNAs in Cancer

The majority of RNAs transcribed from the human genome have no coding capacity and are termed non-coding RNAs (ncRNAs). It is now widely accepted that ncRNAs play key roles in cell regulation and disease. Circular RNAs (circRNAs) are a form of ncRNA, characterised by a closed loop structure with roles as competing endogenous RNAs (ceRNAs), protein interactors and transcriptional regulators. Functioning as key cellular regulators, dysregulated circRNAs have a significant impact on disease progression, particularly in cancer. Evidence is emerging of specific circRNAs having oncogenic or tumour suppressive properties. The multifaceted nature of circRNA function may additionally have merit as a novel therapeutic target, either in treatment or as a novel biomarker, due to their cell-and disease-state specific expression and long-term stability. This review aims to summarise current findings on how circRNAs are dysregulated in cancer, the effects this has on disease progression, and how circRNAs may be targeted or utilised as future potential therapeutic options.

Clinicopathologic and prognostic roles of circular RNA plasmacytoma variant translocation 1 in various cancers

OBJECTIVE

To explore the clinicopathologic and prognostic significance of circular RNA plasmacytoma variant translocation 1 (circPVT1) in various cancers.

METHODS

Several databases were searched for eligible studies published before March 01, 2021. The pooled odds ratios (ORs) with 95% confidence interval (95% CI) were calculated to assess the association between circPVT1 expression and prognostic outcomes of tumor including age, gender, clinical stage, tumor size, metastasis and overall survival. Begg's funnel plots and Egger's test were used to evaluate the publication bias. The robustness of our results was assessed using sensitivity analysis.

RESULTS

Ten studies comprising a total of 878 patients with cancer were included in this meta-analysis. The results showed that the high expression of circPVT1 was significantly related to clinical stage (OR=3.44, 95% CI: 2.40-4.94, P<0.05), tumor size (OR=2.29, 95% CI: 1.38-3.79, P<0.05), metastasis (OR=2.97, 95% CI: 2.06-4.28, p<0.05) and overall survival of cancer (OR=3.30, 95% CI: 2.26-4.84, p<0.05), but not associated with age and gender of patients with tumor. No publication bias was found.

CONCLUSIONS

High expression of circPVT1 may predict an advanced clinical stage and poor prognosis of tumor, suggesting that circPVT1 may serve as a potential prognostic marker in cancers.

Circular RNA circSMARCA5 is a prognostic biomarker in patients with malignant tumor: a meta-analysis

Background

Malignant tumor is one of the most serious diseases endangering human health. Circular RNAs play an important role in the tumorigenesis and progression of various malignant tumors. Although various studies have investigated the biological function of circular RNA circSMARCA5 in malignant tumors, the prognostic value of circSMARCA5 in malignant tumor patients has not been systematically analyzed.

Methods

Relevant studies were obtained from the PubMed and Web of Science database. The quality of the enrolled studies was evaluated using the Newcastle-Ottawa Scale quality assessment system. Survival features and clinicopathological features were assessed using pooled hazard ratios and odds ratios with 95% confidence intervals, respectively.

Results

Overall, 7 relevant publications were enrolled in the meta-analysis. CircSMARCA5 expression was significantly correlated with better OS (HR = 0.51, 95%CI 0.41–0.65) or DFS/RFS/PFS (HR = 0.56, 95%CI 0.43–0.73) in malignant tumors. In the pooled analyses of clinicopathological characteristics, malignant tumors with higher circSMARCA5 were better differentiated (OR = 0.41, 95%CI 0.19–0.88). CircSMARCA5 expression was correlated with less advanced TNM stage (OR = 0.33, 95%CI 0.19–0.55). Moreover, malignant tumors with higher circSMARCA5 expression have less advanced lymph node metastasis (OR = 0.26, 95%CI 0.08–0.79).

Conclusion

These results indicated that circSMARCA5 was a promising biomarker in malignant tumors, which may potentially facilitate clinical decisions in the future.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12885-021-08316-3.

The Emerging Picture of the Roles of CircRNA-CDR1as in Cancer

Circular RNAs (circRNAs) are covalently closed circular structures without 5′ caps and 3′ tails, which are mainly formed from precursor mRNAs (pre-mRNAs) via back-splicing of exons. With the development of RNA sequencing and bioinformatic analysis, circRNAs were recently rediscovered and found to be widely expressed in the tree of life. Cerebellar degeneration-related protein 1 antisense RNA (CDR1as) is recognized as one of the most well-identified circRNAs. It contains over 70 miR-7 binding sites and can regulate gene activity by sponging miR-7. Increasing numbers of studies have recently demonstrated that CDR1as is abnormally expressed in many types of tumors, such as colorectal cancer, cholangiocarcinoma and osteosarcoma, and plays a vital role in the development of cancer. However, there are few reviews focusing on CDR1as and cancer. Hence, it is important to review and discuss the role of CDR1as in cancer. Here, we first review the main biological features of CDR1as. We then focus on the expression and roles of CDR1as in cancer. Finally, we summarize what is known on the role of CDR1as in cancer and discuss future prospects in this area of research.

The Circular RNA-miRNA Axis: A Special RNA Signature Regulatory Transcriptome as a Potential Biomarker for OSCC

Oral squamous cell carcinoma (OSCC) is a highly recurrent form of cancer arising from the oral epithelium, which is the result of mutational change due to etiological factors such as tobacco, smoking, chewing of areca nuts, and alcohol consumption. OSCC occurrence has been observed to be prevalent in different regions of Pacific countries and in most Asian countries. Despite the accessibility of the oral cavity, OSCC is diagnosed at an extremely late stage of pathogenic tumor node metastasis pTNM (III–IV), resulting in a poor prognosis for the individual. Therefore, it is important to make definitive, early, and efficient diagnoses. Owing to the development of omic-natured studies, the presence of proteins, transcribed elements, metabolic products, and even microflora detected in saliva helps us to select biomarkers, which is an especially exciting potential because of the availability and the non-invasive nature of sample collection. Since the discovery of circular RNA (circRNA) by Sanger sequencing, it has been reported to play a pivotal role in several human diseases, including cancer. circRNA functions as a microRNA (miRNA) sponge in the regulation of mRNA expression, forming the circRNA-miRNA regulatory axis. In the case of OSCC, overexpression of different circRNAs exhibits both tumor-progressive and tumor-suppressive effects.

TRPC1 exacerbate metastasis in gastric cancer via ciRS-7/miR-135a-5p/TRPC1 axis

Metastasis is frequently occurred in end-stage GC. Nevertheless, the initiation and progression of metastasis in GC remains unclear. The transient receptor potential canonical (TRPC) has been confirmed to be crucial for metastasis in many kinds of tumors, including GC. However, the molecular mechanisms regulating TRPC1 is unclear. Therefore, we investigated the role and mechanisms of TRPC1 in GC metastasis. We first evaluated the role of TRPC1 in GC by searching the public database, and tested the expression of TRPC1 in 50 paired GC tissues by qRT-PCR and IHC assays. Then, we generated BGC-823-shTRPC1 cells and MKN-45-TRPC1 cells to investigate the effects of TRPC1 on metastasis in vitro. For the mechanism study, we applied luciferase reporter assay, RNA pull-down assay, as well as RIP assay to validate the interation of ciRS-7, miR-135a-5p and TRPC1 in GC cells. This study, we showed that TRPC1 exacerbate EMT in gastric cancer via ciRS-7/miR-135a-5p/TRPC1 axis, and target TRPC1 could be beneficial for end-stage GC patients.

Prognostic and Diagnostic Significance of circRNA Expression in Esophageal Cancer: A Meta-analysis

BACKGROUND AND AIMS

Circular RNA (circRNA) demonstrates potential biological application in various solid tumors. We intended to evaluate the diagnostic, prognostic, and clinicopathological value of circRNA for esophageal cancer (EC).

METHODS

We screened relative studies from Pubmed, Embase, Web of Science, and Cochrane Library. The diagnostic role of circRNAs was testified by pooled sensitivity and specificity. Pooled odds ratio (OR) and pooled hazard ratio (HR) were computed to appraise the clinicopathological and prognostic value, respectively.

RESULTS

There were total 15 articles suitable with our included criteria, in which 7 for diagnosis, 8 for prognosis, and 9 for clinicopathological features. The pooled sensitivity and specificity were 0.77 and 0.80, respectively, while the AUC was 0.85. Patients with aberrant expression of circRNAs had a 2.92-fold increased risk of developing EC. The proportion of EC patients with normal circRNA expression only accounted for 29%. Upregulated expression of oncogenic circRNA was correlated with poor clinicopathological features, including lymph node metastasis, tumor size, and T classification, while downregulation of tumor-suppressor circRNA was contributed to worse TNM stage. As for prognosis, upregulated expression of circRNA carried out a diverse survival outcome, with a pooled HR of 2.76 for tumor promoter and that of 0.21 for tumor suppressor. High expression of oncogenic circRNA in both plasma and tumor tissue would lead to a shorter survival duration.

CONCLUSION

circRNAs might be a promising biomarker for diagnosis, prognosis, and clinicopathological features of EC.