Prognostic Value of Ezrin in Solid Tumors: A Meta-Analysis of the Literature

Abstract

PurposeEzrin is a cytoskeletal protein involved in tumor growth and invasion. However its prognostic value for survival in patients with solid tumor remains controversial.MethodsSeveral databases were searched, including Pubmed, Embase and Cochrane databases. The endpoints were overall survival (OS), progression-free survival (PFS). The pooled hazard ratio (HR) or odds ratio (OR), and 95% confidence intervals (CI) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials.ResultsTwenty-seven eligible trials involving 4693 patients were ultimately identified. A summary hazard ratio (HR) of all studies and sub-group hazard ratios were calculated. The combined HR suggested that a positive Ezrin expression had an impact on overall survival (OS) [1.95, 95% confidence interval (CI) 1.60–2.39; P<0.001] in all eligible studies and progress free survival (PFS): (2.30 95% CI 1.0–3.61; P = 0.001). Similar results were also observed in subgroup analysis, according to tumor types, regions, patients' number and publication year.ConclusionsOur findings suggested that Ezrin protein expression might be a factor for a poor prognosis in patients with solid tumor. So large well-designed prospective studies are now needed to confirm the clinical utility of Ezrin as an independent prognostic marker.

Prognostic Value of Ezrin in Various Cancers: A Systematic Review and Updated Meta-analysis

“…However, the number of inclusion studies in the analysis was not relatively enough and at least 26 eligible studies were not included in the above meta-analysis, of which 8 studies about osteosarcomas were absolutely not included. Furthermore, the data reported by Han et al 68 for the study by Jörgren et al 69 were inconsistent with the data and the conclusion provided by Jörgren et al 69 in their original article. The HR value reported by Han et al 68 for OS is 1.89 (95% CI = 1.16–3.10), this suggested that high Ezrin expression was associated with worse prognosis in rectal cancer patients.…”

“…Furthermore, the data reported by Han et al 68 for the study by Jörgren et al 69 were inconsistent with the data and the conclusion provided by Jörgren et al 69 in their original article. The HR value reported by Han et al 68 for OS is 1.89 (95% CI = 1.16–3.10), this suggested that high Ezrin expression was associated with worse prognosis in rectal cancer patients. But after carefully studying the data presented by Jörgren et al 69 , we found Jörgren et al 69 just provided HR value about LR (local recurrence), not about OS.…”

“…Moreover, the conclusion by Jörgren et al 69 showed that Ezrin expression had no impact on overall survival of patients with rectal cancer. Therefore, the conclusion by Han et al 68 was still being debated and uncertain. In view of this, we performed this updated meta-analysis including 44 articles with 55 studies and elucidated that the high Ezrin expression was significantly associated with poor OS, DFS and DSS/MFS in cancer patients.…”

“…As the first qualitative analysis of Ezrin expression related to survival outcome of various tumors, Han et al 68 retrieved 29 studies and found that over-expression of Ezrin might be associated with worse prognosis. However, the number of inclusion studies in the analysis was not relatively enough and at least 26 eligible studies were not included in the above meta-analysis, of which 8 studies about osteosarcomas were absolutely not included.…”

Genetics of Osteosarcomas

“…Han et al emphasized that the ezrin expression was higher in many cancer types; however, Jörgren et al showed that the ezrin expression had no effect on the overall expression in the overall survival of the patients diagnosed with rectal cancer. [38,39,40] Ezrin, is a member of the protein family that normally binds the cellular skeleton ERM (ezrin, radixin, and moesin). [41] Ezrin occurs mainly in the inactive form in the cytoplasm, and it transforms to a special active form after the activation with treonin and tirosin phosphorylation.…”