AUTHOR=Janani Majid , Poorkhani Amirhoushang , Amiriani Taghi , Donyadideh Ghazaleh , Ahmadi Farahnazsadat , Jorjanisorkhankalateh Yalda , Beheshti-Nia Fereshteh , Kalaei Zahra , Roudbaraki Morad , Soltani Mahsa , Khori Vahid , Alizadeh Ali Mohammad 

TITLE=Association of future cancer metastases with fibroblast activation protein-α: a systematic review and meta-analysis

JOURNAL=Frontiers in Oncology

VOLUME=14

YEAR=2024

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2024.1339050

DOI=10.3389/fonc.2024.1339050

ISSN=2234-943X

ABSTRACT=<sec><title>Introduction</title><p>Fibroblast activation protein-α (FAP-α) is a vital surface marker of cancer-associated fibroblasts, and its high expression is associated with a higher tumor grade and metastasis. A systematic review and a meta-analysis were performed to associate future metastasis with FAP-α expression in cancer.</p></sec><sec><title>Methods</title><p>In our meta-analysis, relevant studies published before 20 February 2024 were systematically searched through online databases that included PubMed, Scopus, and Web of Science. The association between FAP-α expression and metastasis, including distant metastasis, lymph node metastasis, blood vessel invasion, vascular invasion, and neural invasion, was evaluated. A pooled odds ratio (OR) with 95% confidence intervals (CI) was reported as the measure of association.</p></sec><sec><title>Results</title><p>A total of 28meta-analysis. The random-effects model for five parameters showed that a high FAP-α expression was associated with blood vessel invasion (OR: 3.04, 95% CI: 1.54–5.99, <italic>I</italic><sup>2</sup> = 63%, <italic>P</italic> = 0.001), lymphovascular invasion (OR: 3.56, 95% CI: 2.14–5.93, <italic>I</italic><sup>2</sup> = 0.00%, <italic>P</italic> &lt; 0.001), lymph node metastasis (OR: 2.73, 95% CI: 1.96–3.81, <italic>I</italic><sup>2</sup> = 65%, <italic>P</italic> &lt; 0.001), and distant metastasis (OR: 2.59; 95% CI: 1.16–5.79, <italic>I</italic><sup>2</sup> = 81%, <italic>P</italic> &lt; 0.001). However, our analysis showed no statistically significant association between high FAP-α expression and neural invasion (OR: 1.57, 95% CI: 0.84–2.93, <italic>I</italic><sup>2</sup> = 38%, <italic>P</italic> = 0.161).</p></sec><sec><title>Conclusions</title><p>This meta-analysis indicated that cancer cells with a high FAP-α expression have a higher risk of metastasis than those with a low FAP-α expression. These findings support the potential importance of FAP-α as a biomarker for cancer metastasis prediction.</p></sec>