Enhancer of zeste homolog 2 as an independent prognostic marker for cancer: a meta-analysis.

Abstract

BACKGROUND: Novel biomarkers are of particular interest for predicting cancer prognosis. This study aimed to explore the associations between enhancer of zeste homolog 2 (EZH2) and patient survival in various cancers. METHODS: Relevant literature was retrieved from PubMed and Web of Science databases. Pooled hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. RESULTS: Forty-nine studies (8,050 patients) were included. High EZH2 expression was significantly associated with shorter overall (hazard ratio [HR] 1.74, 95% CI: 1.46-2.07), disease-free (HR 1.59, 95% CI: 1.27-1.99), metastasis-free (HR 2.19, 95% CI: 1.38-3.47), progression-free (HR 2.53, 95% CI: 1.52-4.21), cancer-specific (HR 3.13, 95% CI: 1.70-5.74), and disease-specific (HR 2.29, 95% CI: 1.56-3.35) survival, but not recurrence-free survival (HR 1.38, 95% CI: 0.93-2.06). Moreover, EZH2 expression significantly correlated with distant metastasis (OR 3.25, 95% CI: 1.07-9.87) in esophageal carcinoma; differentiation (OR 3.00, 95% CI: 1.37-6.55) in non-small cell lung cancer; TNM stage (OR 3.18, 95% CI: 2.49-4.08) in renal cell carcinoma; and histological grade (OR 4.50, 95% CI: 3.33-6.09), estrogen receptor status (OR 0.15, 95% CI: 0.11-0.20) and progesterone receptor status (OR 0.30, 95% CI: 0.23-0.39) in breast cancer. CONCLUSIONS: Our results suggested that EZH2 might be an independent prognostic factor for multiple survival measures in different cancers.