A systematic review and meta-analysis of higher expression of folate receptor alpha (FOLR1) predicts poor cancer prognosis

Biomarkers. 2020 Jul;25(5):367-374. doi: 10.1080/1354750X.2020.1771420. Epub 2020 Jun 20.

Abstract

Folate receptor alpha (FOLR1), a glycosylphosphatidylinositol-linked protein, is a well characterized folate transporter. However, the prognostic power of FOLR1 in cancer remains controversial. We conducted a meta-analysis to assess the prognostic roles of FOLR1 on different cancers. Twelve studies involving 4471 patients were included in this meta-analysis. The pooled analysis indicated that high FOLR1 significantly predicted poor overall survival (OS) (pooled hazard ratio (HR) = 0.78, 95% confidence interval (CI) = 0.64-0.94, p = 0.009) and the disease-free survival (DFS) (HR = 1.25, 95% CI = 1.07-1.47, p = 0.005). Subgroup analyses based on tumour type found that high FOLR1 level was associated with poor OS in breast cancer (HR = 2.66, 95% CI = 1.54-4.59, p = 0.0005) and endometrial carcinoma (HR = 1.30, 95% CI = 1.05-1.61, p = 0.02). However, FOLR1 has relatively weakly correlation with gender, tumour size and chemotherapy. Additionally, overexpression of FOLR1 was correlated with grade, FIGO stage, vital status and nodule status. The present meta-analysis indicated that the high expression of FOLR1 is associated with the poor survival of cancer patients, which is helpful for the clinical decision-making process.

Keywords: FOLR1; cancer; clinicopathological parameters; meta-analysis; prognosis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Biomarkers, Tumor / genetics*
  • Disease-Free Survival
  • Folate Receptor 1 / genetics*
  • Gene Expression Regulation, Neoplastic / genetics
  • Humans
  • Neoplasms / epidemiology
  • Neoplasms / genetics*
  • Neoplasms / pathology
  • Prognosis*
  • Proportional Hazards Models

Substances

  • Biomarkers, Tumor
  • FOLR1 protein, human
  • Folate Receptor 1