Lee Ju-Han, Kim Seo-Hee, Lee Eung-Seok, Kim Young-Sik
Department of Pathology, The Bioinformatics Interest Group, Korea University Ansan Hospital, Gyeonggi-Do 425-707, Korea.
Oncol Rep. 2009 Nov;22(5):1149-56. doi: 10.3892/or_00000548.
CD24 has emerged as a new oncogene and metastasis promoter. However, there is a controversy as to whether CD24 expression is a prognostic factor for poor outcomes in many human cancers. To shed light on this controversy, we performed a meta-analysis of the relationship between CD24 expression and prognostic parameters in different carcinomas. Studies published in the period 1990-2009 were reviewed for the meta-analysis and selected according to defined criteria. The effect sizes of prognostic parameters and overall survival were calculated by an odds ratio (OR) or an adjusted hazard ratio (HR). Twenty-eight studies reported CD24 expression for 2,925 cases. The frequency of CD24 expression by immunohistochemistry was 68% in all the carcinomas of the breast, female genital tract, gastrointestinal tract, biliary tract and pancreas, urinary system, prostate and skin. Overall, CD24 was more frequently overexpressed in their carcinomas than their benign lesions (OR=4.21; 95% CI, 1.826-9.731; P=0.001) and was significantly associated with lymph node metastasis (OR=2.41; CI, 1.013-5.720; P=0.047), advanced clinical stages (OR=1.59; 95% CI, 1.244-2.032; P<0.001) and shortened overall survival (HR=2.13; 95% CI, 1.656-2.730; P<0.001). CD24 expression was highly associated with lymph node metastases in breast cancer (OR=3.55; 95% CI, 1.664-7.554; P=0.001), advanced clinical stages (OR=2.22; 95% CI, 1.442-3.418; P<0.001) and lymphovascular invasions (OR=2.78; 95% CI, 1.522-5.068; P=0.001) in urothelial carcinomas and with higher grades in endometrial adenocarcinomas (OR=3.88; 95% CI, 1.548-9.715; P=0.004). CD24 was more frequently and strongly expressed in breast (OR=35.80; 95% CI, 8.907-143.921; P<0.001) and ovarian carcinomas (OR=35.92; CI, 7.156-180.311; P<0.001), than in their benign counterparts. In conclusion, the meta-analysis strongly supports the idea that CD24 is an important marker of malignancy and poor prognosis in various cancers. In particular, CD24 may promote cancer development and progression in the breast, ovary and urinary bladder.
CD24已成为一种新的致癌基因和转移促进因子。然而，关于CD24表达是否是许多人类癌症预后不良的一个因素仍存在争议。为了阐明这一争议，我们对不同癌症中CD24表达与预后参数之间的关系进行了荟萃分析。对1990年至2009年期间发表的研究进行综述以进行荟萃分析，并根据既定标准进行选择。通过比值比（OR）或调整后的风险比（HR）计算预后参数和总生存期的效应大小。28项研究报告了2925例病例的CD24表达情况。在乳腺、女性生殖道、胃肠道、胆道和胰腺、泌尿系统、前列腺和皮肤的所有癌症中，免疫组化检测到的CD24表达频率为68%。总体而言，CD24在这些癌症中的过表达频率高于其良性病变（OR = 4.21；95%可信区间，1.826 - 9.731；P = 0.001），并且与淋巴结转移（OR = 2.41；可信区间，1.013 - 5.720；P = 0.047）、晚期临床分期（OR = 1.59；95%可信区间，1.244 - 2.032；P < 0.001）和总生存期缩短（HR = 2.13；95%可信区间，1.656 - 2.730；P < 0.001）显著相关。在乳腺癌中，CD24表达与淋巴结转移（OR = 3.55；95%可信区间，1.664 - 7.554；P = 0.001）、晚期临床分期（OR = 2.22；95%可信区间，1.442 - 3.418；P < 0.001）以及尿路上皮癌中的淋巴管浸润（OR = 2.78；95%可信区间，1.522 - 5.068；P = 0.001）高度相关，在子宫内膜腺癌中与更高的分级相关（OR = 3.88；95%可信区间，1.548 - 9.715；P = 0.004）。CD24在乳腺癌（OR = 35.80；95%可信区间，8.907 - 143.921；P < 0.001）和卵巢癌（OR = 35.92；可信区间，7.156 - 180.311；P < 0.001）中的表达比其良性对应物更频繁且更强。总之，荟萃分析有力地支持了CD24是各种癌症中恶性肿瘤和不良预后的重要标志物这一观点。特别是，CD24可能促进乳腺、卵巢和膀胱中的癌症发展和进展。
