Prognostic Value of Transglutaminase 2 in Patients with Solid Tumors: A Meta-analysis

Transglutaminase 2 (TG2), a member of the transglutaminase family, also known as tissue transglutaminase, plays a fundamental role in cancer growth and progression. In this study, we aimed to comprehensively review the evidence of TG2 as a prognostic biomarker in solid tumors. PubMed, Embase, and Cochrane databases were searched for human studies with clearly described cancer types if they presented the relationship between TG2 expression and prognostic indicators from inception to February 2022. Two authors independently screened the eligible studies and extracted the relevant data. The association between TG2 and overall survival (OS), disease-free survival (DFS), and relapse-free survival (RFS) were described as hazard ratios (HR) and their corresponding 95% confidence intervals (CIs). Statistical heterogeneity was assessed using Cochrane Q-test and Higgins I-squared statistic. A sensitivity analysis was conducted by sequentially omitting the impact of each study. Publication bias was assessed by Egger's funnel plot. A total of 2864 patients with various cancers from 11 individual studies were enrolled. Results showed that elevated TG2 protein expression and mRNA expression predicted a shorter OS, with a combined HR of 1.93 (95% CI: 1.41-2.63) or HR of 1.95 (95% CI: 1.27-2.99), respectively. Moreover, data suggested that elevated TG2 protein expression was correlated with a shorter DFS (HR = 1.76, 95% CI: 1.36-2.29); whereas elevated TG2 mRNA expression was associated with a shorter DFS (HR = 1.71, 95% CI: 1.30-2.24). Our meta-analysis indicated that TG2 might serve as a promising biomarker of cancer prognosis.