A Comparative Meta-Analysis on the Association of lncRNAs MALAT1, HOTAIR, and AFAP1-AS1 With the Risk of Developing Lymph Node Metastasis in Lung Cancer

Sep 21, 2026

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Numerous studies link long noncoding RNAs (lncRNAs) to cancer metastasis, and metastatic lung cancer often shows higher lncRNA expression than nonmetastatic disease. This study examined whether three lncRNAs—MALAT1, HOTAIR, and AFAP1-AS1—are associated with lymph node metastasis (LNM) in lung cancer. Searches across major databases selected 17 publications (1622 patients) for quantitative analysis and quality assessment. Results indicate elevated MALAT1, HOTAIR, and AFAP1-AS1 expression correlates with LNM risk, with AFAP1-AS1 showing the strongest alignment across external database analyses.

LanguageEnglish

CategoryResearch & Report

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Pages17

Reading Time43 min

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Abstract

Background

Objectives

Methods

Results

Conclusion

Introduction

Cancer Reports REVIEW OPEN ACCESS A Comparative Meta-Analysis on the Association of lncRNAs MALAT1, HOTAIR, and AFAP1-AS1 With the Risk of Developing Lymph Node Metastasis in Lung Cancer Anha Tasnim | Afra Anjum Sumaiya | Abdullah Al Noman | Anika Tahsin | Abdullah Al Saba | Rubaiat Ahmed | Tahirah Yasmin | A. H. M. Nurun Nabi Laboratory of Population Genetics, Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, Bangladesh Correspondence: A. H. M. Nurun Nabi ([nabi@du.ac.bd](nabi@du.ac.bd)) Received: 4 February 2024 | Revised: 21 November 2024 | Accepted: 3 December 2024 Funding: The authors received no specific funding for this work. Keywords: AFAP1-AS1 | HOTAIR | lung cancer | lymph node metastasis | MALAT-1 ABSTRACT Background: Numerous studies have demonstrated the significance of long noncoding RNA (lncRNA) in the development of cancer metastasis. The expression levels of many lncRNAs are elevated in metastatic lung cancer patients compared to nonmetastatic lung cancer patients. Objectives: The primary objective of the study was to investigate the association between the expression levels of three lncRNAs (MALAT1, HOTAIR, and AFAP1-AS1) and lymph node metastasis (LNM) of lung cancer. Methods: Cell Press, PubMed, SpringerLink, Web of Science, and Google Scholar were explored to perform the literature search. After screening 1862 articles, 66 English-language articles were selected based on the inclusion and exclusion criteria. From those articles, 17 publications comprising 1622 lung cancer patients were chosen for statistical analyses as well as quality assessment tests. Results: Forest plot analysis revealed that there was a significant difference in the incidence of LNM between the high and low MALAT1 expression groups (OR = 3.21, 95% CI: 1.34–7.67; random effects model) . Significant differences were also observed in the incidence of LNM between patients with high and low HOTAIR expression levels (OR = 4.17, 95% CI: 1.47–11.82; random effects model). The expression level of AFAP1-AS1 was found to be significantly associated with LNM in lung cancer (OR = 2.31, 95% CI: 1.39–3.85, random effects model) . Additional analysis from GEPIA and GEO databases revealed that the expression levels ofthese lncRNAs vary according to the type of tumor tissue, organ of metastasis, and cancer stage. However, these databases show that the result for AFAP1-AS1 is the most aligned with the meta-analysis's findings. Furthermore, several quality assessment tests showed that the AFAP1-AS1 studies are more reliable compared to the studies of other lncRNAs. Conclusion: This study suggested that LNM in lung cancer patients is associated mostly with an elevated AFAP1-AS1 lncRNA level among the pool of three lncRNAs analyzed. Before these results can be implemented in a clinical setting, it is essential to conduct further validation and undertake comprehensive analysis to ensure robustness and reliability. | Anha Tasnim and Afra Anjum Sumaiya these authors contributed equally as the first author. | | --- | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2024 The Author(s). Cancer Reports published by Wiley Periodicals LLC. | Cancer Reports, 2024; 7:e70091 1 of 17 [https://doi.org/10.1002/cnr2.70091](https://doi.org/10.1002/cnr2.70091) 1 | Introduction Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths [1] . Among different types of cancer, lung cancer is one of the most prevalent ones. It constitutes one of the most common cancersin Asia with a high mortality rate [2]. It is one of the most prevalent cancers in Bangladesh, ranked among the top two prevalent cancers in males in Bangladesh [3] . Several studies on various aspects of lung cancer have been

FAQs

What was the main objective of this comparative meta-analysis?

To assess the association between expression levels of MALAT1, HOTAIR, and AFAP1-AS1 and lymph node metastasis in lung cancer.

Which databases and screening steps were used to select studies?

Literature was searched in Cell Press, PubMed, SpringerLink, Web of Science, and Google Scholar; 1862 articles were screened and 17 publications (1622 patients) met inclusion criteria for analysis and quality assessment.

What did the meta-analysis find about MALAT1 and HOTAIR in relation to LNM risk?

High MALAT1 expression was associated with LNM incidence (OR=3.21, 95% CI: 1.34–7.67), and high HOTAIR expression was also associated with LNM incidence (OR=4.17, 95% CI: 1.47–11.82) under random effects models.

Which lncRNA showed the strongest alignment with the meta-analysis results, and what is the next step?

AFAP1-AS1 showed the strongest alignment with meta-analysis findings across GEPIA and GEO; further validation and comprehensive analyses are needed before clinical implementation.

Sep 21, 2026

Uploaded by Theodora