Prognostic significance of FAT10 expression in malignant tumors: a systematic review and meta-analysis

<b>Aim:</b> FAT10, a ubiquitin-like modifier protein, influences apoptosis, DNA damage response and tumor growth, with unclear effects on cancer prognosis. <b>Methods:</b> We reviewed <i>FAT10</i> expression's impact on malignancy prognosis through a systematic review and meta-analysis, including studies up to September 2023 from PubMed, EMBASE and Web of Science. <b>Results:</b> From 18 studies involving 2513 patients, <i>FAT10</i> overexpression significantly reduced overall and disease-free survival across various tumors, indicating correlations with advanced disease stage, poor differentiation, lymph node metastasis and larger tumor size. <b>Conclusion:</b><i>FAT10</i>‘s overexpression suggests a negative prognostic value in cancer, meriting further investigation. <b>PROSPERO Registration Number:</b> CRD42023431287 This study investigated a protein called FAT10, which is involved in how cells behave, including how cancer cells grow and survive. It analyzed previous research to see if high levels of FAT10 in patients with cancer can help predict how serious their cancer is and how it might progress. After reviewing 18 studies involving 2513 patients, we found that patients with more FAT10 in their cells often had a worse outlook, including a higher chance of the cancer returning and a shorter overall survival time. This pattern existed for different types of cancer. Our findings suggest that measuring FAT10 levels could be helpful for doctors to better understand a patient's cancer and choose the best treatment. However, more studies are needed to confirm our results. FAT10, a ubiquitin-like modifier protein, is implicated in apoptosis, the DNA damage response and tumor development, with its overexpression found in various malignancies. This systematic review and meta-analysis aggregated data from published studies on the prognostic significance of FAT10 in malignant tumors, focusing on overall survival (OS) and disease-free survival (DFS). This study included 18 studies with 2513 patients, showing <i>FAT10</i> overexpression correlated with poor OS (HR: 1.85) and DFS (HR: 2.63). Subgroup analyses across tumor types confirmed the consistent negative effect of <i>FAT10</i> overexpression on survival outcomes. <i>FAT10</i> overexpression also correlated with advanced TNM stage, differentiation grade, lymph node metastasis and tumor size. The meta-analysis found that <i>FAT10</i> could be a negative prognostic biomarker in malignant tumors and help predict patient outcomes and guide targeted therapy. This study had some limitations, including a focus on a limited number of cancer types and the inclusion of mostly retrospective studies from mainland China, which could affect the generalizability of its findings.