NF-κB Expression and Outcomes in Solid Tumors A Systematic Review and Meta-Analysis

Nuclear factor-kappaB (NF-B) is a key inflammatory transcription factor expressed frequently in tumors. Numerous studies have investigated the correlation between NF-B expression and prognosis in solid tumors, but the conclusions are still in contradiction. Here, we conduct a meta-analysis to explore the overall association of NF-B overexpression and survival in human solid tumors.Pubmed and EBSCO databases were searched for studies evaluating expression of NF-B (as measured by immunohistochemistry) and overall survival (OS) and disease-free survival (DFS) in solid tumors. Published data were extracted and computed into odds ratios (ORs) for death at 3, 5, and 10 years. Data were pooled using the Mantel-Haenszel random-effect model. All statistical tests were two-sided.Forty-four studies with a total of 4418 patients were included in this meta-analysis. NF-B overexpression was associated with worse OS at 3 years (OR=3.40, 95% confidence interval [CI]=2.41-4.79, P<0.00001), 5 years (OR=2.72, 95% CI=1.92-3.85, P<0.00001), and 10 years (OR=2.63, 95% CI=1.34-5.16, P=0.005) of solid tumors. Results for 3- and 5-year DFS were similar. NF-B expression was associated with poor 3-year OS in both Tumor, Lymph Node, Metastasis stage I-II (OR=9.11, 95% CI=2.90-28.68, P=0.0002) and III-IV (OR=2.59, 95% CI=1.61-4.15, P<0.0001). There is no correlation between cellular localization of NF-kB overexpression and OS of solid tumors. Among the tumor types, NF-B was associated with worse 3 year-OS of colorectal cancer (OR=2.70, 95% CI=1.64-4.46, P<0.0001), esophageal carcinoma (OR=6.00, 95% CI=3.29-10.94, P<0.0001) and worse 5 year-OS of colorectal cancer (OR=2.72, 95% CI=1.92-3.85, P<0.00001), esophageal carcinoma (OR=5.96, 95% CI=3.48-10.18, P=0.03), and nonsmall cell lung cancer (OR=1.69, 95% CI=1.20-2.38, P=0.002).Expression of NF-B is associated with worse survival in most solid tumors irrespective of NF-B localization.