标题：Prognostic significance of FOXM1 in digestive system cancers: a systematic review and meta-analysis
作者：Han, Jie; Cui, Jianfeng; Chen, Pengxiang; Zhang, Hui; Zhu, Yingming; Zhang, Nasha; Wang, Miaomiao; Rasool, Khurram; Yu, Jinming
作者机构：[Han, Jie; Zhu, Yingming; Zhang, Nasha; Rasool, Khurram; Yu, Jinming] Shandong Univ, Shandong Canc Hosp & Inst, Dept Radiat Oncol, 440 Jiyan Rd, Jinan 更多
通讯作者地址：[Yu, JM]Shandong Univ, Shandong Canc Hosp & Inst, Dept Radiat Oncol, 440 Jiyan Rd, Jinan 250000, Shandong, Peoples R China.
来源：INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
关键词：FOXM1; digestive system cancer; tumor prognosis; meta-analysis
摘要：Forkhead box M1 (FOXM1) has been revealed to play a regulatory role in tumor progression. The overexpression of FOXM1 is associated with the poor prognosis of patients with various types of neoplasms. A meta-analysis was conducted to assess the relationship between FOXM1 and several critical parameters in patients with digestive system cancer (DSC). Observational studies (up to January 2016) from PubMed, Embase and the Cochrane Library were searched. The hazard ratios (HRs) and relative risks (RRs) with 95% confidence intervals (CIs) measured the correlation between FOXM1 and the clinical parameters of the patients. Random or fixed effects models were applied for the analysis according to the value of the I-2 statistic. Cross-trial heterogeneity was quantified by the Q and I-2 statistics, while Begg's and Egger's tests were utilized to evaluate the publication bias. Eleven studies with 1512 cases of DSC were found using the search strategy and the inclusion criteria. When the high expression of FOXM1 was compared with the low expression of FOXM1 in tumors, the pooled HR of the overall survival was 2.01 (95% CI = 1.70-2.36, P < 0.001). Our analysis also revealed that the overexpression of FOXM1 tended to be associated with more lymph node metastasis (RR = 1.26, 95% CI = 1.09-1.45, P = 0.006), more vascular invasion (RR = 1.64, 95% CI = 1.09-2.47, P = 0.017) and higher clinical stage (RR = 1.70, 95% CI = 1.20-2.40, P = 0.003). Our analysis was determined to be stable after a sensitivity analysis and publication bias tests. In conclusion, the upregulated expression of FOXM1 in patients with DSC is significantly related to poorer survival, earlier lymph node metastasis, more severe vascular invasion and higher clinical stage.