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PTEN genomic deletion defines favorable prognostic biomarkers in localized prostate cancer: a systematic review and meta-analysis.

UNLABELLED
PTEN (10q23.3) is a negative regulator of the phosphatidylinositol 3-kinase (PIK3)/Akt survival pathway and a tumor suppressor frequently deleted in prostate cancer. PTEN genomic deletion is among the most common genetic aberrations in human prostate cancer. At present, the prognostic value of PTEN genomic deletion is unclear. We performed a systematic review and meta-analysis to clarify the association between PTEN genomic deletion and a higher Gleason score or a higher possibility of capsular penetration. A comprehensive, computerized literature search of PubMed was carried out until May 27, 2014. Studies were included according to specific inclusion criteria. Pooled hazard ratio was estimated using the fixed effects model or random effects model according to heterogeneity between studies. Seven eligible studies meeting the specific inclusion criteria were selected for further analysis; all were retrospective studies. Overall meta-analysis demonstrated that PTEN genomic deletion was associated with a higher Gleason score (OR 0.319; 95% confidence interval: 0.153-0.666; P = 0.000) and a higher possibility of capsular penetration (OR 0.393; 95% confidence interval: 0.185-0.837; P = 0.015). None of the studies materially altered the original results and no evidence of publication bias was found.


CONCLUSION
PTEN genomic deletion in operable localized prostate cancer indicates a higher Gleason score and a higher probability of capsular penetration, indicating a worse prognosis. Further studies should be conducted in order to investigate the effect of PTEN genomic deletion on clinical outcomes in different histological types of prostate cancer or its function in castration-resistant prostate cancer.