Increased lncRNA AFAP1‐AS1 expression predicts poor prognosis in gastric cancer: Evidence from published studies and followed up verification

AIM: The purpose of this study was to clarify the influence of long non‐coding RNA actin fiber‐associated protein‐1 antisense RNA 1 (lncRNA AFAP1‐AS1) on the prognosis of gastric cancer (GC). METHODS: Based on meta‐analysis, the association between the expression of AFAP1‐AS1 and the prognosis of GC was estimated. GC tissue and non‐cancer tissues from 136 patients were determined by quantitative real‐time reverse transcription polymerase chain reaction (qRT‐PCR) and verified by Gene Expression Profiling Interactive Analysis (GEPIA). Kaplan–Meier and Cox proportional hazards models were conducted to analyze the correlation between AFAP1‐AS1 expression and GC prognosis. RESULTS: The pooled analysis from five studies revealed that the AFAP1‐AS1 expression was significantly associated with GC overall survival (hazard ratio (HR) = 2.49 and 95% confidence interval (95% CI): 2.02–3.08, p < 0.001). Compared with non‐cancer tissues, AFAP1‐AS1 expression level of GC tissues were significantly upregulated (p < 0.001), which was confirmed by the results of GEPIA. The area under the receiver‐operating characteristic (ROC) curve was 0.893, and the high expression of AFAP1‐AS1 was correlated with poor prognosis in patients with GC (p = 0.005). Clinical grade (HR = 1.912, 95% CI: 1.246–2.934, p = 0.003), pathologic tumor node metastasis (pTNM) (HR = 2.393, 95% CI: 1.431–4.033, p = 0.001), log odds of positive lymph nodes (LODDS) (HR = 2.910, 95% CI: 1.787–4.793, p < 0.001) and AFAP1‐AS1 expression (HR = 2.393, 95% CI: 1.869–3.064, p < 0.001) were independent prognostic factors for GC revealed by multivariate Cox‐regression analysis. CONCLUSION: This study demonstrated that the AFAP1‐AS1 may be a novel biomarker for the diagnosis and prognosis of GC.