Overexpression of ANXA2 predicts adverse outcomes of patients with malignant tumors: a systematic review and meta-analysis

Accumulated evidence has indicated a correlation between annexin A2 (ANXA2) and malignancy progression. However, whether ANXA2 expression can be considered as a prognostic factor for cancer patients remains controversial. This meta-analysis aimed to explore the prognostic value of ANXA2 overexpression. A systematically comprehensive search for studies investigating the relationships between ANXA2 expression and outcome of malignant tumor patients was performed using PubMed and EMBASE. Prognostic value of ANXA2 expression in malignancy patients was evaluated regarding overall survival (OS), disease-free survival (DFS) and various clinicopathological features measured by pooled hazard ratios (HRs) or odds ratios and their 95 % confidence intervals (CIs). Fifteen studies including 2,321 patients were enrolled in the meta-analysis. Our results showed that the overexpression of ANXA2 was correlated with poor prognosis in terms of OS (HR 1.56; 95 % CI 1.24–1.97; P < 0.001) and DFS (HR 1.47; 95 % CI 1.18–1.83; P < 0.001) in patients with malignant tumors. In addition, ANXA2 overexpression was significantly associated with tumor invasion (HR 2.06; 95 % CI 1.47–2.89; P < 0.001) and lymph node metastasis (HR 2.25; 95 % CI 1.21–4.15; P = 0.01). However, when age, tumor stage, histological grade and distant metastasis were considered, no obvious association was observed. Publication bias was absent. Sensitivity analysis suggested that the results of this meta-analysis were robust. The present meta-analysis results indicated that ANXA2 overexpression might be associated with poor outcomes in patients with malignant tumors.