Rev Esp Enferm Dig. 2022 Sep 30.
BACKGROUND: Colorectal cancer (CRC) is the most common carcinoma worldwide, but a lack of effective prognostic markers limits the clinical diagnosis and treatment. Yes-associated protein 1 (YAP1) is an effector of the HIPPO-pathway, which plays a critical role in cancer development and prognosis, including CRC. However, previous reports have suggested that it plays a dual role in CRC.
METHODS: A meta-analysis using RevMan software 5.4 and Stata 14.0 was performed to evaluate the relationship between YAP1 and clinical outcomes of CRC, after searching for eligible studies from the PubMed, Web of Science and Embase databases. Online datasets GEPIA and LOGpc were also used to calculate survival results and compare with the meta-analysis results. Besides, "DESeq" packages was used for expression analysis of YAP1 from TCGA dataset.
RESULTS: YAP1 was over expression in the tissue of cancers comparing to normal tissues in patients with CRC from TCGA database (p=0.000164) and GEPIA database. A total of 10 studies involving 2305 patients from literatures were selected. Pooled HR indicated that over-expression of YAP1 was associated with poor clinical outcomes (HR=1.70, 95% CI: 1.28-2.26, p=0.0003). Subgroup analysis showed a clear correlation between over-expression of YAP1 and worse survival rate in Chinese patients (HR=1.94, 95% CI: 1.40-2.69, p=0.0001), nuclear YAP1 over-expression (HR=2.07, 95% CI: 1.29-3.31, p=0.003), 60 months follow-up duration (HR=1.89, 95% CI: 1.30-2.73, p=0.0008), IHC test (HR=1.65, 95% CI: 1.17-2.33, p=0.005), IHC combined with other tests (HR=1.77, 95% CI: 1.13-2.77, p=0.01) and multivariate analysis (HR=1.70, 95% CI: 1.24-2.31, p=0.0009). Nevertheless, disease-free survival (DFS) did not show significant result in the patients with CRC in our meta-analysis (HR=1.38, 95% CI: 0.51-3.75, p=0.52) as well as in the GEPIA and LOGpc databases. Meanwhile, YAP1 over-expression was also significantly associated with worse overall survival (OS) in GSE17536, GSE40967, GSE29623 and GSE71187.
CONCLUSION: YAP1 over-expression is common in CRC tissues. Over-expression of YAP1 in CRC patients, particularly in the nucleus, might be related to shorter OS, maybe in the early stages. YAP1 could serve as a potential predictor of poor prognosis in CRC.
Keywords: YAP1; colorectal cancer; meta-analysis online databases.; prognosis