Background: Aberrations in the expression of the transcription factor forkhead box C2 (FOXC2) have been linked to a number of malignancies. Here, we characterized the relationship between FOXC2 and cancer progression by conducting a metaanalysis of studies that reported the frequency of FOXC2 expression in tumors of different stages (T1, T2, T3, T4). Methods: Relevant articles were retrieved from the Medline database by searching for the terms "FOXC2" and "cancer" then, the retrieved articles were reviewed individually, and studies that were of multivariate cohort design, evaluated FOXC2 expression via immunohistochemical staining, and assessed the relationship between FOXC2 expression and cancer T-stage were included in our meta-analysis. Results: Our search terms identified 139 studies, 9 of which met all inclusion criteria. A total of 1433 tumor samples were evaluated in the 9 studies; 596 samples were from early-stage (T1-T2) tumors, and 838 were from late-stage (T3-T4) tumors. FOXC2 was expressed in 46.0% of all samples, in 32.4% of early-stage tumor samples, and in 55.6% of late-stage tumor samples. When calculated relative to early-stage samples, the pooled risk for FOXC2 expression in late-stage samples was 1.367 (95% CI = 1.103-1.695, p = 0.004). Conclusion: The results from our meta-analysis of 9 studies indicate that FOXC2 is 36.7% more likely to be expressed in late-stage tumors than in early-stage tumors.
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