Han Jun, Meng Qing-Yang, Liu Xiao, Xi Qiu-Lei, Zhuang Qiu-Lin, Wu Guo-Hao
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China E-mail :
Asian Pac J Cancer Prev. 2014;15(14):5551-6. doi: 10.7314/apjcp.2014.15.14.5551.
The prognostic value of human epidermal growth factor receptor-2 (HER-2/neu) for survival of patients with colorectal cancer (CRC) is still ambiguous. We therefore performed a meta-analysis to evaluate its prognostic significance.
We searched the MEDLINE and EMBASE databases for published literature investigating associations between HER-2/neu status and overall survival of patients with CRC. A meta-analysis was performed using a DerSimonian-Laird model and publication bias was investigated by Begg's and Egger's tests. Subgroup analysis was also conducted according to the study design type, study quality score, cut-off value for HER-2/neu overexpression, publication region, patient number and publication year.
A total of 17 eligible studies involving 2,347 patients were identified for this meta-analysis. The combined hazard ratio (HR) was 1.31 (95% confidence interval (CI): 0.96-1.79), suggesting that HER-2/neu overexpression was not significantly associated with overall survival of patients with CRC. However, subgroup analysis revealed that HER-2/neu overexpression had an unfavorable impact on survival when the analysis was restricted to subgroups of study quality score ≤ 5 (HR=1.56, 95%CI: 1.17-2.10), Asian patients (HR=1.74, 95%CI: 1.22-2.49), patient number ≤ 106 (HR=1.57, 95%CI: 1.01-2.44), publication year before 2003 (HR=1.59, 95%CI: 1.02-2.49), and prospectively designed study (HR=3.62, 95%CI: 1.42-9.24). The effect disappeared in subgroups of study quality scores > 5 (HR=0.69, 95%CI: 0.33-1.44), non Asian patients (HR=1.14, 95%CI: 0.77-1.70), patients' number > 106 (HR=1.07, 95%CI: 0.67-1.72), publication year after 2003 (HR=1.13, 95%CI: 0.76-1.69), and retrospectively designed study (HR=1.22, 95%CI: 0.89-1.67).
Our meta-analysis suggests that HER-2/neu overexpression might not be a significantly prognostic indicator for patients with CRC. Further studies are required to confirm these results.
人表皮生长因子受体2（HER-2/neu）对结直肠癌（CRC）患者生存的预后价值仍不明确。因此，我们进行了一项荟萃分析以评估其预后意义。
我们在MEDLINE和EMBASE数据库中检索已发表的文献，研究HER-2/neu状态与CRC患者总生存之间的关联。使用DerSimonian-Laird模型进行荟萃分析，并通过Begg检验和Egger检验研究发表偏倚。还根据研究设计类型、研究质量评分、HER-2/neu过表达的临界值、发表地区、患者数量和发表年份进行亚组分析。
本荟萃分析共纳入17项符合条件的研究，涉及2347例患者。合并风险比（HR）为1.31（95%置信区间（CI）：0.96 - 1.79），表明HER-2/neu过表达与CRC患者的总生存无显著关联。然而，亚组分析显示，当分析限于研究质量评分≤5的亚组（HR = 1.56，95%CI：1.17 - 2.10）、亚洲患者（HR = 1.74，95%CI：1.22 - 2.49）、患者数量≤106的亚组（HR = 1.57，95%CI：1.01 - 2.44）、2003年前发表年份的亚组（HR = 1.59，95%CI：1.02 - 2.49）以及前瞻性设计研究的亚组（HR = 3.62，95%CI：1.42 - 9.24）时，HER-2/neu过表达对生存有不利影响。在研究质量评分>5的亚组（HR = 0.69，95%CI：0.33 - 1.44）、非亚洲患者（HR = 1.14，95%CI：0.77 - 1.70）、患者数量>106的亚组（HR = 1.07，95%CI：0.67 - 1.72）、2003年后发表年份的亚组（HR = 1.13，95%CI：0.76 - 1.69）以及回顾性设计研究的亚组（HR = 1.22，95%CI：0.89 - 1.67）中，该效应消失。
我们的荟萃分析表明，HER-2/neu过表达可能不是CRC患者的显著预后指标。需要进一步研究来证实这些结果。
