Urinary EN-2 to predict prostate cancer: Systematic review and meta-analysis

Abstract

Introduction: Prostate cancer is the second type of cancer diagnosed and the fifth cause of death in men worldwide. Early diagnosis helps to control disease progression. Currently, prostate specific antigen is the standard biomarker, as it has a broad scope of identification and, thus, new and more specific biomarkers must be studied. Objective: To evaluate the accuracy of engrailed-2 protein (EN2) in urine as a prostate cancer biomarker. Method: A comprehensive search was conducted in the period from January 2005 to July 2016 using the following electronic databases: Medline (PubMed), Embase, Cochrane Library and Lilacs. The keywords used in the databases were: "engrailed-2," "EN2," "prostatic neoplasms." The search was limited to humans and there was no language restriction. Critical appraisal of the included studies was performed according to Quadas-2. Statistical analysis was performed using Meta-DiSc® and RevMan 5.3 softwares. Results: A total of 248 studies were identified. After title and abstract screening, 231 studies were removed. A total of 17 studies were read in full and two studies were included in the meta-analysis. The pooled sensitivity was 66% (95CI 0.56-0.75) and specificity was 89% (95CI 0.86-0.92). The DOR was 15.08 . Conclusion: The EN2 test showed high specificity (89%) and low sensitivity (66%).

microRNA-27b inhibits cell proliferation and invasion in bladder cancer by targeting engrailed-2

“…This study indicated that there was downregulation of miR-27b-3p and upregulation of EN2 in BC tissues and cells, implicating a reciprocal action between miR-27b-3p and EN2 in the process of in prostate cancer, indicating that the urinary EN2 presented a high specificity (89%) and low sensitivity (66%) (24). Urinary EN2 may also be an early non-invasive diagnostic biomarker for BC.…”

Altered staining patterns and expression level of Engrailed-2 in Benign prostatic hyperplasia and Prostate Cancer predict Prostatic disease progression

“…The EN2 protein we used as immunogen has been confirmed to be the main functional structural domain of EN2's exocrine and internalization [18,19]. Some studies also showed this part of EN2 is available to produce detectable antibodies for PC patients' urine test [20,21]. The monoclonal antibody against this part of EN2 could present different staining pattern in BPH and PC.…”

Engrailed 2 (EN2) acts as a glioma suppressor by inhibiting tumor proliferation/invasion and enhancing sensitivity to temozolomide

“…EN2 is a member of the homeobox family, which encodes a homeodomain-containing transcription factor that is essential for early development. Elevation of EN2 has been highly correlated with the proliferation, invasion, and migration in several types of malignancies [18][19][20][21][22][23][24][25][26], however, controversial results show that EN2 is silenced in other cancers [27][28][29], and thus EN2 acts as a potential diagnostic and prognostic biomarker [23,[30][31][32][33]. However, decreased EN2 in renal carcinoma has been observed and downregulation of EN2 in 786-O cell line promoted proliferation and reduced apoptosis [27,34,35].…”