Department of Medical Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
J Thorac Oncol. 2010 Dec;5(12):1922-32. doi: 10.1097/jto.0b013e3181f26266.
Human epidermal growth factor receptor 2 (HER2) is regarded as a poor prognostic factor in many tumors. Conflicting data in many literatures were reported about the association between HER2 and poor prognosis in lung cancer.
We conducted a meta-analysis of published studies from 1966 to the 12th week of 2010. In absence of significant quality difference between positive and negative studies, combined hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated in terms of overall survival.
Forty studies(6135 patients) were included in the analysis. The pooled data showed that HER2 overexpression was a marker of poor prognosis in lung cancer. HR was 1.48 (95% CI: 1.22-1.80) and 3.11 (95% CI: 2.26-4.28) for non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) by immunohistochemistry (IHC) assay, respectively. In the NSCLC subgroup analysis of early stage and ethnicities using IHC and in SCLC subgroup of extensive stage using IHC, it also showed that HER2 overexpression determined by IHC was a marker of poor prognosis in NSCLC and SCLC. In other subgroup of squamous cell carcinoma tested by IHC, the combined HR was 0.87 (95% CI: 0.61-1.25), indicating that HER2 overexpression was not a prognostic factor for squamous cell carcinoma. Finally, in the subgroup analysis of HER2 amplification status of NSCLC using fluorescence in situ hybridization, we also found that HER2 amplification determined by fluorescence in situ hybridization was not significantly related to prognosis.
Although bias could be inevitable, this meta-analysis suggests that HER2 overexpression is a poor prognostic factor in lung cancer, especially for SCLC, adenocarcinoma, and early-stage NSCLC.
人类表皮生长因子受体 2（HER2）被认为是许多肿瘤的不良预后因素。在许多文献中报道了 HER2 与肺癌不良预后之间的关联存在矛盾的数据。
我们对 1966 年至 2010 年第 12 周发表的研究进行了荟萃分析。在阳性和阴性研究之间没有显著的质量差异的情况下，根据总生存计算了合并的危险比（HR）及其相应的 95％置信区间（CI）。
共有 40 项研究（6135 例患者）纳入分析。汇总数据显示，HER2 过表达是肺癌不良预后的标志物。免疫组织化学（IHC）检测结果显示，非小细胞肺癌（NSCLC）和小细胞肺癌（SCLC）的 HR 分别为 1.48（95％CI：1.22-1.80）和 3.11（95％CI：2.26-4.28）。在 NSCLC 的 IHC 早期阶段和种族亚组分析以及 SCLC 的 IHC 广泛阶段亚组分析中，也表明 IHC 检测的 HER2 过表达是 NSCLC 和 SCLC 的不良预后标志物。在 IHC 检测的鳞状细胞癌的其他亚组中，合并的 HR 为 0.87（95％CI：0.61-1.25），表明 HER2 过表达不是鳞状细胞癌的预后因素。最后，在 NSCLC 的荧光原位杂交检测 HER2 扩增状态的亚组分析中，我们还发现荧光原位杂交检测的 HER2 扩增与预后无显著相关性。
尽管可能存在偏倚，但这项荟萃分析表明，HER2 过表达是肺癌的不良预后因素，特别是对于 SCLC、腺癌和早期 NSCLC。
