PTEN in kidney cancer: A review and meta-analysis

Background: Kidney cancer is one of the most common cancers in the USA causing 14,400 deaths per year. The phosphatase and tensin homolog (PTEN) has been extensively documented as a tumor suppresser gene in cancer. However, there is unclear evidence for its clinicopathological and prognostic role in kidney cancer. Methods: A systematic review of literature assessing PTEN expression and clinical outcome in patients with kidney cancer. Web of Science, PubMed, Embase, and Chinese databases were searched for collecting for the eligible studies providing sufficient information. Pooled odds ratios (ORs) and hazard ratios (HRs) were respectively used to evaluate the association between PTEN levels and the clinicopathological features and clinical outcomes. Results: A total of 35 studies enrolling 4532 patients were finally included in this study. For the survival outcome, the result suggested that shorter overall survival (OS) was correlated with low PTEN expression (HR = 0.57, 95% CIs: 0.45-0.74, P < 0.0001). The meta-analysis indicated a significantly increased risk of tumorigenesis in the PTEN low-level group relative to the control group (OR = 0.098, 95% CIs: 0.067-0.143, P < 0.001). Moreover, the results displayed the positive correlation between poorer differentiation (OR = 0.234, 95% CIs: 0.133-0.410, P < 0.001), distant metastasis (OR = 0.179, 95% CIs: 0.092-0.350, P = 0.001), lymph node metastasis (OR = 0.252, 95% CIs: 0.113-0.563, P < 0.001), advanced clinical stages (OR = 0.233, 95% CI: 0.133, 0.406, P < 0.001) and low PTEN expression. Finally, there was no obvious publication bias found in the meta-analysis. Conclusions: Decreased PTEN was associated with poorer survival outcomes of patients with kidney cancer and PTEN acts as a tumor suppressor in tumorigeneses and progression in kidney cancer.