ATP5B Expression as a Prognostic Biomarker in Solid Tumors: A Systematic Review and Meta-Analysis

INTRODUCTION/OBJECTIVE: Mitochondrial ATP synthase F1 subunit beta (ATP5B) is involved in the catalytic process of oxidative phosphorylation (OXPHOS). However, the prognostic value of ATP5B remains conflicting. Therefore, a systematic meta-analysis is needed to assess the prognostic value of ATP5B in solid tumors. METHODS: A search for articles in multiple databases, including PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data, was carried out for records up to June 1st, 2025. The analysis of the association between ATP5B expression levels and overall survival (OS) was conducted by calculating pooled hazard ratios (HRs) and 95% confidence intervals (CIs). Heterogeneity was measured via the I² statistic and Cochran's Q test. Subgroup analyses were performed to determine heterogeneity in ethnicity, cancer type, treatment regimen, data extraction method, sample size, and test target. Sensitivity and publication bias analyses were also performed. RESULTS: This meta-analysis included 12 studies (15 cohorts) with 2,344 patients. The results showed that high ATP5B expression was significantly associated with poor OS (HR = 1.95, 95%CI: 1.29-2.94). In subgroup analyses, reduced heterogeneity between studies was observed in the melanoma subgroup (I² = 44%), in studies based on mRNA expression (I² = 0%), and in studies with large sample sizes (I² = 0%). No significant bias was detected in the publication bias analysis. DISCUSSION: This first meta-analysis confirms the potential of ATP5B as a prognostic biomarker in solid tumors. High ATP5B expression is associated with poor prognosis, supporting its role as a pan-cancer indicator. More high-quality studies with large samples and standardized detection protocols are needed to further clarify the prognostic value of ATP5B, so that it may become a widely used biomarker in clinical practice. CONCLUSION: High ATP5B expression may independently predict inferior survival outcomes in patients with solid tumors.