Prognostic and Clinicopathological Value of SIRT3 Expression in Various Cancers: a Systematic Review and Meta-analysis

Background: Several studies have explored the prognostic value of sirtuin 3 (SIRT3) in various cancers, but obtained inconsistent results. The current systematic review and meta-analysis was conducted to investigate the association between SIRT3 expression and prognosis in various cancers.

Methods: PubMed, Embase, Web of Science and the Cochrane Library were comprehensively retrieved by the end of September 29, 2017. All the relevant studies were checked and included in the meta-analysis if they met the inclusion criteria.

Results: A total of 17 studies involving 2,865 patients were included in the systematic review and meta-analysis. The results indicated that SIRT3 expression was not significantly associated with overall survival (OS) (hazard ratio [HR]=0.87, 95% CI=0.59-1.29, =0.50) and disease-free survival (HR=0.87, 95% CI=0.57-1.31, =0.50) in total various cancers. However, significant relationship between SIRT3 expression and OS in specific cancers was detected, including chronic lymphocytic leukemia (CLL) (HR=0.48, 95% CI=0.26-0.89, =0.019), hepatocellular carcinoma (HCC) (HR=0.56, 95% CI=0.42-0.74, <0.001), pancreatic carcinoma (PC) (HR=0.55, 95% CI=0.30-1.00, =0.049), renal cell carcinoma (RCC) (HR=0.13, 95% CI=0.02-0.98, =0.048), breast cancer (BC) (HR=2.53, 95% CI=1.83-3.67, <0.001), colon cancer (CC) (HR=1.87, 95% CI=1.12-3.26, =0.022) and non-small-cell lung cancer (NSCLC) (HR=2.20, 95% CI=1.38-3.50, =0.001). Moreover, SIRT3 expression was obviously associated with tumor size (odds ratio [OR]=1.41, 95% CI=1.02-1.94, =0.04), tumor differentiation (OR=1.52, 95% CI=1.08-2.16, =0.02) and clinical stage (OR=2.07, 95% CI=1.23-3.46, =0.01) in HCC.

Conclusion: SIRT3 was distinctly related to the OS in specific cancers. SIRT3 was an unfavorable prognostic factor in BC, CC and NSCLC; however, it was also a favorable prognostic factor in CLL, HCC, PC and RCC, especially in HCC.