Karyopherin (KPNA) is a nuclear transport protein that interacts with cellular cargo through a nuclear localization signal. The cellular transport system is frequently dysfunctional in cancer cells. KPNA2, a subset of the KPNA family, is expressed at high levels in a range of cancers, including breast and lung cancers. However, just a few studies have looked into KPNA2 expression in colorectal cancer (CRC). This systematic review and meta-analysis aimed to determine the prognostic significance of karyopherin alpha 2 (KPNA2) for patients with CRC.
As of 15 July 2021, two authors performed an independent English full-text literature search on KPNA2 and CRC sourcing from PubMed, EuroPMC, and the Cochrane Library (keywords: KPNA2, karyopherin alpha 2, prognosis, outcome, colorectal cancer, colon cancer, rectal cancer, and neoplasm). Primary outcomes include disease-free survival (DFS) and overall survival (OS). All types of study design were considered suitable, except non-primary publications (grey and white literature), non-human studies, and studies with a population < 18 years of age. High KPNA2 expression referred to the final score obtained for the product of the intensity score and the percentage score with a cutoff value of 4 points. We used the Odds Ratio (OR) to analyze it, and we report it as OR with a 95% confidence interval (CI). The random-effects model was employed to analyze the data. The Newcastle Ottawa Scale was used to assess the overall quality of evidence in all of the studies examined (NOS).
From a total of 3013 studies retrieved, we identified four unique studies compromising of 910 samples biopsied. High KPNA2 level was expressed in 459 patients, whereas the remaining 451 had low expression. From meta-analysis, we found that KPNA2 was not associated with DFS (OR 1.72 [1.27, 2.32]; p=0.98); I2 = 0%) and OS (OR 1.78 [1.43, 2.23]; p=0.59); I2 = 0%). After all, the fitted studies are good in quality.
This study demonstrated that KPNA2 was not associated with disease-free survival and overall survival rate.
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