Haijie Xie, Bin Xie, Chunyu Liu, Jun Wang, Yong Xu

Among men, prostate cancer (PCa) is one of the most commonly diagnosed cancers and the leading cause of cancer death worldwide. Phosphatase and tension homolog (PTEN) acts as a negative regulator of the phosphatidylinositol 3-kinase (PIK3)/Akt pathway and suppresses tumor progression. Meanwhile, PTEN is frequently deleted in PCa. Identifying the specific molecular markers of biochemical recurrence (BCR) in PCa patients is critical in clinical practice. Our systematic review summarizes the evidence about the PTEN expression and BCR rate in PCa patients. To clarify the impact of PTEN expression on the PCa BCR rate, a systematic review and meta-analysis was performed by searching the PubMed, Embase, and Web of Science databases, to identify the relevant literature. The analysis of pooled data was performed with Stata 12. The combined odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were evaluated by the fixed-effects or random-effects models. The combined sensitivity and publication bias were also estimated. In total, nine articles containing ten independent cohort studies, including 2,154 cases with positive expression of PTEN and 1,006 PTEN deletion cases, were deemed eligible for the meta-analysis. Overall, the positive expression of PTEN was associated with a significantly lower BCR rate (OR =0.521, 95% CI: 0.431-0.630). Subgroup analysis stratified by race revealed that in multiple races (OR =0.215, 95% CI: 0.072-0.648) and Caucasian (OR =0.469, 95% CI: 0.373-0.591) races, positive expression of PTEN showed a significant association with lower BCR rate. Subgroup analysis also showed the significant result in different sample sizes. PTEN deletion has a relationship with a higher BCR rate in PCa compared with positive expression of PTEN.