Potential use of HOTAIR and MALAT1 as prognostic biomarkers for cervical cancer: An application to the NHS

Large loop excision of the transformation zone (LLETZ) is a common treatment for women who display grade 3 cervical intraepithelial neoplasia (CIN3). However, 78% of women report physical side effects and 71% of women report psychological effects after treatment. Furthermore, 76% of women report feeling rushed into the decision to undergo treatment, with no other monitoring option provided, highlighting the need for a less invasive monitoring procedure to be offered to patients. Long non-coding RNAs (LncRNAs) are non-coding RNA more than 200bp that display an abundance within serum. Previous research has associated the expression levels of several lncRNAs, such as Homeobox transcript antisense RNA (HOTAIR) and Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), with the commencement and progression of cervical cancer. This systematic review and meta-analysis aimed to evaluate the prognostic significance of HOTAIR and MALAT1 within the serum and tissue of cervical cancer patients. A literature search was conducted by three independent researchers spanning four databases. Using a PICOS inclusion and exclusion criteria, six identified studies (n=826) reported on the correlation between lncRNA expression and clinicopathological features in cervical cancer. HOTAIR or MALAT1 were significantly upregulated in cervical cancer patients compared to matched healthy participants (P =