Skip to main content
Top
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

Prognostic and clinicopathological significance of MLKL expression in cancer patients: a meta-analysis

Authors: Binwu Hu, Deyao Shi, Xiao Lv, Songfeng Chen, Qin Huang, Mao Xie, Zengwu Shao

Published in: BMC Cancer | Issue 1/2018

Login to get access

Abstract

Background

MLKL is the most important executor of necroptosis pathway. Recent studies have demonstrated that MLKL could serve as a potential prognostic biomarker for cancer patients. However, most studies reported so far are limited in discrete outcome and sample size.

Methods

We systematically searched PubMed, Embase, Web of Science and CNKI to obtain all relevant articles about the prognostic value of abnormally expressed MLKL in patients with any type of tumor. Odds ratios or hazards ratios (HRs) with corresponding 95% confidence intervals (CIs) were pooled to estimate the association between MLKL expression and clinicopathological characteristics or survival of cancer patients.

Results

A total of 6 eligible studies with 613 cancer patients were enrolled in our meta-analysis. Our results demonstrated that decreased expression level of MLKL was significantly associated with poor overall survival (OS) (pooled HR 0.26, 95%CI 0.17–0.40, high/low) and event-free survival (EFS) (pooled HR 0.45, 95%CI 0.23–0.87, high/low) in cancer patients. Furthermore, subgroup analysis divided by type of cancer, sample size, follow-up time and Newcastle–Ottawa Scale (NOS) score showed consistent prognostic value. In addition, our analysis revealed that decreased expression level of MLKL was significantly associated with advanced tumor stage, more lymph node metastasis and older age.

Conclusions

In conclusion, our meta-analysis suggested that decreased MLKL expression might be a convinced unfavorable prognostic factor that could help the clinical decision-making process.
Literature
1.
2.
go back to reference Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115–32.CrossRefPubMed Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115–32.CrossRefPubMed
3.
go back to reference Shi XS, Li J, Yang RH, Zhao GR, Zhou HP, Zeng WX, Zhou M. Correlation of increased MALAT1 expression with pathological features and prognosis in cancer patients: a meta-analysis. Genet Mol Res. 2015;14(4):18808–19.CrossRefPubMed Shi XS, Li J, Yang RH, Zhao GR, Zhou HP, Zeng WX, Zhou M. Correlation of increased MALAT1 expression with pathological features and prognosis in cancer patients: a meta-analysis. Genet Mol Res. 2015;14(4):18808–19.CrossRefPubMed
4.
go back to reference Cui Z, Chen Y, Xiao Z, Hu M, Lin Y, Chen Y, Zheng Y. Long noncoding RNAs as auxiliary biomarkers for gastric cancer screening: a pooled analysis of individual studies. Oncotarget. 2016;7(18):25791–800.PubMedPubMedCentral Cui Z, Chen Y, Xiao Z, Hu M, Lin Y, Chen Y, Zheng Y. Long noncoding RNAs as auxiliary biomarkers for gastric cancer screening: a pooled analysis of individual studies. Oncotarget. 2016;7(18):25791–800.PubMedPubMedCentral
5.
go back to reference Li J, Yang Z, Li Y, Xia J, Li D, Li H, Ren M, Liao Y, Yu S, Chen Y, et al. Cell apoptosis, autophagy and necroptosis in osteosarcoma treatment. Oncotarget. 2016;7(28):44763–78.PubMedPubMedCentral Li J, Yang Z, Li Y, Xia J, Li D, Li H, Ren M, Liao Y, Yu S, Chen Y, et al. Cell apoptosis, autophagy and necroptosis in osteosarcoma treatment. Oncotarget. 2016;7(28):44763–78.PubMedPubMedCentral
7.
go back to reference Venkatramani R, Wang L, Malvar J, Dias D, Sposto R, Malogolowkin MH, Mascarenhas L. Tumor necrosis predicts survival following neo-adjuvant chemotherapy for hepatoblastoma. Pediatr Blood Cancer. 2012;59(3):493–8.CrossRefPubMed Venkatramani R, Wang L, Malvar J, Dias D, Sposto R, Malogolowkin MH, Mascarenhas L. Tumor necrosis predicts survival following neo-adjuvant chemotherapy for hepatoblastoma. Pediatr Blood Cancer. 2012;59(3):493–8.CrossRefPubMed
8.
go back to reference Vandenabeele P, Galluzzi L, Vanden Berghe T, Kroemer G. Molecular mechanisms of necroptosis: an ordered cellular explosion. Nat Rev Mol Cell Biol. 2010;11(10):700–14.CrossRefPubMed Vandenabeele P, Galluzzi L, Vanden Berghe T, Kroemer G. Molecular mechanisms of necroptosis: an ordered cellular explosion. Nat Rev Mol Cell Biol. 2010;11(10):700–14.CrossRefPubMed
9.
go back to reference Jouan-Lanhouet S, Riquet F, Duprez L, Vanden Berghe T, Takahashi N, Vandenabeele P. Necroptosis, in vivo detection in experimental disease models. Semin Cell Dev Biol. 2014;35:2–13.CrossRefPubMed Jouan-Lanhouet S, Riquet F, Duprez L, Vanden Berghe T, Takahashi N, Vandenabeele P. Necroptosis, in vivo detection in experimental disease models. Semin Cell Dev Biol. 2014;35:2–13.CrossRefPubMed
10.
go back to reference Cai Z, Jitkaew S, Zhao J, Chiang HC, Choksi S, Liu J, Ward Y, Wu LG, Liu ZG. Plasma membrane translocation of trimerized MLKL protein is required for TNF-induced necroptosis. Nat Cell Biol. 2014;16(1):55–65.CrossRefPubMed Cai Z, Jitkaew S, Zhao J, Chiang HC, Choksi S, Liu J, Ward Y, Wu LG, Liu ZG. Plasma membrane translocation of trimerized MLKL protein is required for TNF-induced necroptosis. Nat Cell Biol. 2014;16(1):55–65.CrossRefPubMed
11.
go back to reference Chen D, Yu J, Zhang L. Necroptosis: an alternative cell death program defending against cancer. Biochim Biophys Acta. 2016;1865(2):228–36.PubMedPubMedCentral Chen D, Yu J, Zhang L. Necroptosis: an alternative cell death program defending against cancer. Biochim Biophys Acta. 2016;1865(2):228–36.PubMedPubMedCentral
12.
go back to reference Liu P, Xu B, Shen W, Zhu H, Wu W, Fu Y, Chen H, Dong H, Zhu Y, Miao K, et al. Dysregulation of TNFalpha-induced necroptotic signaling in chronic lymphocytic leukemia: suppression of CYLD gene by LEF1. Leukemia. 2012;26(6):1293–300.CrossRefPubMed Liu P, Xu B, Shen W, Zhu H, Wu W, Fu Y, Chen H, Dong H, Zhu Y, Miao K, et al. Dysregulation of TNFalpha-induced necroptotic signaling in chronic lymphocytic leukemia: suppression of CYLD gene by LEF1. Leukemia. 2012;26(6):1293–300.CrossRefPubMed
13.
go back to reference Koo GB, Morgan MJ, Lee DG, Kim WJ, Yoon JH, Koo JS, Kim SI, Kim SJ, Son MK, Hong SS, et al. Methylation-dependent loss of RIP3 expression in cancer represses programmed necrosis in response to chemotherapeutics. Cell Res. 2015;25(6):707–25.CrossRefPubMedPubMedCentral Koo GB, Morgan MJ, Lee DG, Kim WJ, Yoon JH, Koo JS, Kim SI, Kim SJ, Son MK, Hong SS, et al. Methylation-dependent loss of RIP3 expression in cancer represses programmed necrosis in response to chemotherapeutics. Cell Res. 2015;25(6):707–25.CrossRefPubMedPubMedCentral
14.
go back to reference Moriwaki K, Bertin J, Gough PJ, Orlowski GM, Chan FK. Differential roles of RIPK1 and RIPK3 in TNF-induced necroptosis and chemotherapeutic agent-induced cell death. Cell Death Dis. 2015;6:e1636.CrossRefPubMedPubMedCentral Moriwaki K, Bertin J, Gough PJ, Orlowski GM, Chan FK. Differential roles of RIPK1 and RIPK3 in TNF-induced necroptosis and chemotherapeutic agent-induced cell death. Cell Death Dis. 2015;6:e1636.CrossRefPubMedPubMedCentral
15.
go back to reference Fukasawa M, Kimura M, Morita S, Matsubara K, Yamanaka S, Endo C, Sakurada A, Sato M, Kondo T, Horii A, et al. Microarray analysis of promoter methylation in lung cancers. J Hum Genet. 2006;51(4):368–74.CrossRefPubMed Fukasawa M, Kimura M, Morita S, Matsubara K, Yamanaka S, Endo C, Sakurada A, Sato M, Kondo T, Horii A, et al. Microarray analysis of promoter methylation in lung cancers. J Hum Genet. 2006;51(4):368–74.CrossRefPubMed
16.
go back to reference McCormick KD, Ghosh A, Trivedi S, Wang L, Coyne CB, Ferris RL, Sarkar SN. Innate immune signaling through differential RIPK1 expression promote tumor progression in head and neck squamous cell carcinoma. Carcinogenesis. 2016;37(5):522–9.CrossRefPubMedPubMedCentral McCormick KD, Ghosh A, Trivedi S, Wang L, Coyne CB, Ferris RL, Sarkar SN. Innate immune signaling through differential RIPK1 expression promote tumor progression in head and neck squamous cell carcinoma. Carcinogenesis. 2016;37(5):522–9.CrossRefPubMedPubMedCentral
17.
go back to reference Cerhan JR, Ansell SM, Fredericksen ZS, Kay NE, Liebow M, Call TG, Dogan A, Cunningham JM, Wang AH, Liu-Mares W, et al. Genetic variation in 1253 immune and inflammation genes and risk of non-Hodgkin lymphoma. Blood. 2007;110(13):4455–63.CrossRefPubMedPubMedCentral Cerhan JR, Ansell SM, Fredericksen ZS, Kay NE, Liebow M, Call TG, Dogan A, Cunningham JM, Wang AH, Liu-Mares W, et al. Genetic variation in 1253 immune and inflammation genes and risk of non-Hodgkin lymphoma. Blood. 2007;110(13):4455–63.CrossRefPubMedPubMedCentral
18.
19.
go back to reference Xu F, Yang R, Wu L, He Q, Zhang Z, Zhang Q, Yang Y, Guo J, Chang C, Li X. Overexpression of BMI1 confers clonal cells resistance to apoptosis and contributes to adverse prognosis in myelodysplastic syndrome. Cancer Lett. 2012;317(1):33–40.CrossRefPubMed Xu F, Yang R, Wu L, He Q, Zhang Z, Zhang Q, Yang Y, Guo J, Chang C, Li X. Overexpression of BMI1 confers clonal cells resistance to apoptosis and contributes to adverse prognosis in myelodysplastic syndrome. Cancer Lett. 2012;317(1):33–40.CrossRefPubMed
20.
21.
go back to reference Li X, Guo J, Ding A-P, Qi W-W, Zhang P-H, Lv J, Qiu W-S, Sun Z-Q. Association of Mixed Lineage Kinase Domain-like Protein Expression with Prognosis in patients with Colon Cancer. Technology in Cancer Research & Treatment. 2017;16(4):428–34.CrossRef Li X, Guo J, Ding A-P, Qi W-W, Zhang P-H, Lv J, Qiu W-S, Sun Z-Q. Association of Mixed Lineage Kinase Domain-like Protein Expression with Prognosis in patients with Colon Cancer. Technology in Cancer Research & Treatment. 2017;16(4):428–34.CrossRef
22.
go back to reference He L, Peng K, Liu Y, Xiong J, Zhu FF. Low expression of mixed lineage kinase domain-like protein is associated with poor prognosis in ovarian cancer patients. OncoTargets and Therapy. 2013;6:1539–43.PubMedPubMedCentral He L, Peng K, Liu Y, Xiong J, Zhu FF. Low expression of mixed lineage kinase domain-like protein is associated with poor prognosis in ovarian cancer patients. OncoTargets and Therapy. 2013;6:1539–43.PubMedPubMedCentral
23.
go back to reference Zhai E, Chen J, Wang K, Ye Z, Wu H, Chen C, Qin C, Chen S, He Y, Cai S. Prognostic value of mixed lineage kinase domain-like protein expression in the survival of patients with gastric caner. Tumor Biol. 2016;37(10):13679–85.CrossRef Zhai E, Chen J, Wang K, Ye Z, Wu H, Chen C, Qin C, Chen S, He Y, Cai S. Prognostic value of mixed lineage kinase domain-like protein expression in the survival of patients with gastric caner. Tumor Biol. 2016;37(10):13679–85.CrossRef
24.
go back to reference Zhu J, Zeng Z, Wei J, Lv Y, Tang L. Application of MLKL protein on patients with breast Cancer after radical surgery. J JinzhouMedical University. 2017;38(4):11–4. Zhu J, Zeng Z, Wei J, Lv Y, Tang L. Application of MLKL protein on patients with breast Cancer after radical surgery. J JinzhouMedical University. 2017;38(4):11–4.
25.
go back to reference Ruan J, Mei L, Zhu Q, Shi G, Wang H. Mixed lineage kinase domain-like protein is a prognostic biomarker for cervical squamous cell cancer. Int J Clin Exp Pathol. 2015;8(11):15035–8.PubMedPubMedCentral Ruan J, Mei L, Zhu Q, Shi G, Wang H. Mixed lineage kinase domain-like protein is a prognostic biomarker for cervical squamous cell cancer. Int J Clin Exp Pathol. 2015;8(11):15035–8.PubMedPubMedCentral
26.
go back to reference Colbert LE, Fisher SB, Hardy CW, Hall WA, Saka B, Shelton JW, Petrova AV, Warren MD, Pantazides BG, Gandhi K, et al. Pronecrotic mixed lineage kinase domain-like protein expression is a prognostic biomarker in patients with early-stage resected pancreatic adenocarcinoma. Cancer. 2013;119(17):3148–55.CrossRefPubMed Colbert LE, Fisher SB, Hardy CW, Hall WA, Saka B, Shelton JW, Petrova AV, Warren MD, Pantazides BG, Gandhi K, et al. Pronecrotic mixed lineage kinase domain-like protein expression is a prognostic biomarker in patients with early-stage resected pancreatic adenocarcinoma. Cancer. 2013;119(17):3148–55.CrossRefPubMed
27.
go back to reference Altman DG, McShane LM, Sauerbrei W, Taube SE. Reporting recommendations for tumor marker prognostic studies (REMARK): explanation and elaboration. PLoS Med. 2012;9(5):e1001216.CrossRefPubMedPubMedCentral Altman DG, McShane LM, Sauerbrei W, Taube SE. Reporting recommendations for tumor marker prognostic studies (REMARK): explanation and elaboration. PLoS Med. 2012;9(5):e1001216.CrossRefPubMedPubMedCentral
28.
go back to reference McShane LM, Altman DG, Sauerbrei W, Taube SE, Gion M, Clark GM. Reporting recommendations for tumor marker prognostic studies (REMARK). J Natl Cancer Inst. 2005;97(16):1180–4.CrossRefPubMed McShane LM, Altman DG, Sauerbrei W, Taube SE, Gion M, Clark GM. Reporting recommendations for tumor marker prognostic studies (REMARK). J Natl Cancer Inst. 2005;97(16):1180–4.CrossRefPubMed
29.
go back to reference Parmar MK, Torri V, Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med. 1998;17(24):2815–34.CrossRefPubMed Parmar MK, Torri V, Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med. 1998;17(24):2815–34.CrossRefPubMed
30.
go back to reference Sun L, Wang H, Wang Z, He S, Chen S, Liao D, Wang L, Yan J, Liu W, Lei X, et al. Mixed lineage kinase domain-like protein mediates necrosis signaling downstream of RIP3 kinase. Cell. 2012;148(1–2):213–27.CrossRefPubMed Sun L, Wang H, Wang Z, He S, Chen S, Liao D, Wang L, Yan J, Liu W, Lei X, et al. Mixed lineage kinase domain-like protein mediates necrosis signaling downstream of RIP3 kinase. Cell. 2012;148(1–2):213–27.CrossRefPubMed
31.
go back to reference Meng MB, Wang HH, Cui YL, Wu ZQ, Shi YY, Zaorsky NG, Deng L, Yuan ZY, Lu Y, Wang P. Necroptosis in tumorigenesis, activation of anti-tumor immunity, and cancer therapy. Oncotarget. 2016;7(35):57391–413.CrossRefPubMedPubMedCentral Meng MB, Wang HH, Cui YL, Wu ZQ, Shi YY, Zaorsky NG, Deng L, Yuan ZY, Lu Y, Wang P. Necroptosis in tumorigenesis, activation of anti-tumor immunity, and cancer therapy. Oncotarget. 2016;7(35):57391–413.CrossRefPubMedPubMedCentral
Metadata
Title
Prognostic and clinicopathological significance of MLKL expression in cancer patients: a meta-analysis
Authors
Binwu Hu
Deyao Shi
Xiao Lv
Songfeng Chen
Qin Huang
Mao Xie
Zengwu Shao
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4655-4

Other articles of this Issue 1/2018

BMC Cancer 1/2018 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine