Competing Endogenous RNA Networks Reveal Long Non-coding RNAs as Potential Prognostic Biomarkers in Gastric Cancer: A Systematic Review and Meta-Analysis

Background: Gastric cancer (GC) represents a global healthcare challenge. Recently, many competing endogenous RNA (ceRNA) network studies have elucidated critical long noncoding RNAs (lncRNAs) as potential prognostic biomarkers in GC. Since there is no systematic review and meta-analysis regarding the lncRNAs as ceRNA in GC, we propose the current study. Materials and Methods: The Web of Science, Embase, PubMed, Scopus, ProQuest, and Google Scholar databases were searched to collect eligible ceRNA network studies in which lncRNAs were reported as prognostic biomarkers until 20 th September 2024. Prognostic values of highly reported lncRNAs were examined. Furthermore, sensitivity analysis, and publication bias were evaluated. Results: Totally, 56 studies were included in the systematic review. Based on these studies, the association of 350 unique lncRNAs with overall survival of GC patients were evaluated. 28 studies were eligible for meta-analysis. Four lncRNAs including ADAMTS9-AS2 , AL391152.1 , CCDC144NL-AS1 , and PVT1 were the most reported prognostic biomarkers. Meta-analysis confirmed the prognostic effect of CCDC144NL-AS1 (hazard ratio (HR) = 1.577 (95% confidence interval (CI): 1.382-1.801) in GC. Conclusion: Our meta-analysis demonstrated potential application of lncRNA CCDC144NL-AS1 based on the ceRNA network studies as a promising prognostic biomarker in GC. Further studies are needed to elucidate the functions of this lncRNA in GC. Registration: The review protocol was registered on The International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022360864).