Abstract
Ezrin is a member of the ezrin-radixin-moesin (ERM) protein family and has been shown to be associated with poor prognosis in patients with a variety of solid tumors. However, the clinical prognostic significance of ezrin in patients with bone and soft tissue sarcomas remains unclear. Here, we performed a systematic meta-analysis by searching PubMed, the Cochrane Library Database, EMBASE, the Web of Science, and the CBM, WanFang Med Online and CNKI databases. In total, 19 studies with a total of 1316 bone and soft tissue sarcoma patients were included. Pooled analyses showed that ezrin overexpression was correlated with a higher rate of tumor metastasis (OR 6.59, 95% CI: 2.84-15.33, P < 0.01, P(FDR) < 0.01) and recurrence (OR 3.18, 95% CI: 1.88-5.37, P < 0.01, P(FDR) < 0.01) and a more advanced tumor grade (OR 3.252, 95% CI: 1.371-7.715, P = 0.01, P(FDR) = 0.03). Moreover, elevated ezrin expression could predict poor OS (HR 3.02, 95% CI: 2.35-3.89, P < 0.01, P(FDR) < 0.01), MFS (HR 5.22, 95% CI: 2.08-13.08, P < 0.01, P(FDR) < 0.01), and EFS (HR 1.07, 95% CI: 1.03-1.11, P < 0.01, P(FDR) < 0.01). Subgroup analyses revealed the underlying sources of heterogeneity. Publication bias was observed in the analysis of metastasis. Sensitivity analysis revealed that the results were robust. Our findings indicated that ezrin overexpression was significantly correlated with poor survival and more advanced tumor progression in bone and soft tissue sarcomas, which suggests that ezrin might be a valuable prognostic biomarker and a potential therapeutic target.