Background: The nicotinamide nucleotide transhydrogenase antisense RNA 1 (NNT-AS1) is a long non-coding RNA aberrantly expressed in human malignancies. We aimed to analyze available data to evaluate the correlation between NNT-AS1 expression and cancer prognosis.
Methods: Literature retrieval was performed by systematic searching related databases from inception to April 2, 2020. Studies regarding correlation between NNT-AS1 expression, survival outcomes and clinical characteristics of cancer patients were collected and pooled to calculate the the hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (95% CIs).
Results: Ten studies comprising 699 patients were included, all of which were conducted in China according to literature selection criteria. Overexpression of NNT-AS1 had a significant association with unfavorable overall survival (OS) (HR=2.08, 95% CI: 1.84-2.36, P<0.001). Stratified analysis showed that tumor type, sample size, follow-up months, and survival analysis approach did not change the predictive value of NNT-AS1 on OS. Furthermore, elevated NNT-AS1 level had significant association with distant metastasis (DM) (OR=2.45, 95% CI: 1.39-4.30), lymph node metastasis (LNM) (OR=3.92, 95% CI: 1.35-11.41), TNM stage (OR=4.25, 95% CI: 1.71-10.56), and vascular invasion (OR=3.98, 95% CI: 2.06-7.71), but was not associated with age and gender. The TCGA dataset further consistently showed that the NNT-AS1 expression was associated with poor OS and disease-free survival.
Conclusions: High expression of NNT-AS1 is associated with unfavorable survival outcomes and poor clinicopathologic characteristics. However, large-cohort data and geographical studies are still needed to further validate the prognostic value of NNT-AS1 in cancers.

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This is a list of supplementary files associated with this preprint. Click to download.
Additional file 1: Table S1 PRISMA Checklist.
Additional file 2: Table S2 Study quality and bias in the retrospective cohort studies judged by the Newcastle-Ottawa Scale (NOS) checklist.
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On 31 Aug, 2020
On 26 Aug, 2020
Posted 07 Aug, 2020
On 02 Aug, 2020
Received 02 Aug, 2020
Invitations sent on 31 Jul, 2020
On 31 Jul, 2020
On 30 Jul, 2020
On 29 Jul, 2020
On 29 Jul, 2020
On 05 Jul, 2020
Received 17 Jun, 2020
Received 16 Jun, 2020
On 17 May, 2020
On 14 May, 2020
Invitations sent on 09 Apr, 2020
On 06 Apr, 2020
On 05 Apr, 2020
On 05 Apr, 2020
On 05 Apr, 2020
On 31 Aug, 2020
On 26 Aug, 2020
Posted 07 Aug, 2020
On 02 Aug, 2020
Received 02 Aug, 2020
Invitations sent on 31 Jul, 2020
On 31 Jul, 2020
On 30 Jul, 2020
On 29 Jul, 2020
On 29 Jul, 2020
On 05 Jul, 2020
Received 17 Jun, 2020
Received 16 Jun, 2020
On 17 May, 2020
On 14 May, 2020
Invitations sent on 09 Apr, 2020
On 06 Apr, 2020
On 05 Apr, 2020
On 05 Apr, 2020
On 05 Apr, 2020
Background: The nicotinamide nucleotide transhydrogenase antisense RNA 1 (NNT-AS1) is a long non-coding RNA aberrantly expressed in human malignancies. We aimed to analyze available data to evaluate the correlation between NNT-AS1 expression and cancer prognosis.
Methods: Literature retrieval was performed by systematic searching related databases from inception to April 2, 2020. Studies regarding correlation between NNT-AS1 expression, survival outcomes and clinical characteristics of cancer patients were collected and pooled to calculate the the hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (95% CIs).
Results: Ten studies comprising 699 patients were included, all of which were conducted in China according to literature selection criteria. Overexpression of NNT-AS1 had a significant association with unfavorable overall survival (OS) (HR=2.08, 95% CI: 1.84-2.36, P<0.001). Stratified analysis showed that tumor type, sample size, follow-up months, and survival analysis approach did not change the predictive value of NNT-AS1 on OS. Furthermore, elevated NNT-AS1 level had significant association with distant metastasis (DM) (OR=2.45, 95% CI: 1.39-4.30), lymph node metastasis (LNM) (OR=3.92, 95% CI: 1.35-11.41), TNM stage (OR=4.25, 95% CI: 1.71-10.56), and vascular invasion (OR=3.98, 95% CI: 2.06-7.71), but was not associated with age and gender. The TCGA dataset further consistently showed that the NNT-AS1 expression was associated with poor OS and disease-free survival.
Conclusions: High expression of NNT-AS1 is associated with unfavorable survival outcomes and poor clinicopathologic characteristics. However, large-cohort data and geographical studies are still needed to further validate the prognostic value of NNT-AS1 in cancers.

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6
This is a list of supplementary files associated with this preprint. Click to download.
Additional file 1: Table S1 PRISMA Checklist.
Additional file 2: Table S2 Study quality and bias in the retrospective cohort studies judged by the Newcastle-Ottawa Scale (NOS) checklist.
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