Prognostic role of circRNAs and RNA methylation enzymes in bladder cancer: A systematic review and meta-analysis of Chinese studies.

In recent years, some circRNAs and RNA methylation enzymes (including RNA methyltransferases and RNA demethylases) have been reported to be associated to the prognosis of bladder cancer, but the findings have been inconsistent. Therefore, the aims of this study is to comprehensively evaluate the prognostic value of circRNAs and RNA methylation enzymes as a whole in bladder cancer by Meta-analysis. A comprehensive literature search was performed in PubMed, Cochrane Library, EMbase, Web of Science, CNKI, WanFang, and VIP databases from the establishment of the database to March 2024. Data were extracted from the included literature and statistically analyzed using Stata 18.0 MP. (1) Overall survival (OS): high expression of circRNAs decreased OS of bladder cancer (HR = 1.74, 95% CI: 1.26-2.41, P = 0.001); and high fat mass and obesity-associated protein (FTO) expression led to poor OS in bladder cancer (HR = 2.38, 95% CI: 1.08-2.25, P = 0.032). (2) Disease-free survival (DFS): low circRNAs expression resulted in poor DFS (HR = 1.74, 95% CI: 1.38-2.18, P < 0.001); (3) Recurrence-free survival (RFS): high expression of circ-CCT3 and circ-RHOT1 decreased bladder cancer patients' RFS (HR = 2.26, 95% CI: 1.63-3.12, P < 0.001); and low expression of circ0004826 and circ0077837 also affected RFS (HR = 0.19, 95% CI: 0.08-0.43, P < 0.001). (4) 5-year survival: high expression of circRNAs decreased 5-year survival of bladder cancer patients (HR = 3.26, 95% CI: 1.90-5.57, P < 0.001). CircRNAs and FTO can be prognostic factors for bladder cancer.