Wu Ying, Li Zhi, Zhang Chenlu, Yu Kai, Teng Zan, Zheng Guoliang, Wang Shuang, Liu Yunpeng, Cui Lei, Yu Xiaosong
Department of General Practice, The First Hospital, China Medical University Shenyang 110001, Liaoning, China.
Department of Oncology, The First Hospital, China Medical University Shenyang 110001, Liaoning, China.
Int J Clin Exp Med. 2015 Mar 15;8(3):3595-606. eCollection 2015.
With a meta-analysis and narrative review, we evaluated the clinical and prognostic role of all CD44 family proteins in gastric cancer (GC). Literatures published up to August 2014 were searched on PubMed. Among the 37 eligible studies (6606 patients), 34 were included in meta-analysis, and 10 were subjected to narrative review. With meta-analysis, standard CD44 (CD44s) was demonstrated to predict reduced overall survival (OS) (HR = 1.93, 95% CI: 1.58-2.34, PHR = 0.0222) and disease free survival (HR = 3.13, 95% CI: 1.02-9.68, PHR = 0.0469), advanced N-stage (RR = 1.12, 95% CI: 1.04-1.21, PRR = 0.0019), and distant metastasis (RR = 2.14, 95% CI: 1.46-3.14, PRR < 0.0001) of GC. CD44 variant 6 (CD44v6) in GC might influence OS (5 studies; HR = 1.27, 95% CI: 0.75-2.14, PHR = 0.3783; 4 studies; HR = 1.52, 95% CI: 1.09-2.14, PHR = 0.0139), while significantly associated with N-stage (RR = 1.23, 95% CI: 1.03-1.48, PRR = 0.0240), M-stage (RR = 2.54, 95% CI: 1.08-6.00, PRR = 0.0333), TNM-stage (RR = 1.72, 95% CI: 1.18-2.50, PRR = 0.0045), Lauren type (RR = 0.67, 95% CI: 0.50-0.91, PRR = 0.0106), lymphatic invasion (RR = 1.13, 95% CI: 1.04-1.23, PRR = 0.0057), and liver metastasis (RR = 3.20, 95% CI: 1.94-5.27, PRR < 0.0001) of the disease. Moreover, a narrative review was performed for CD44 isoforms, such as v3, v5, v7, v8-10, and v9, in GC. In conclusion, CD44s and CD44v6 as evaluated by immunohistochemistry, respectively, predicts the prognosis and disease severity of GC.
通过荟萃分析和叙述性综述，我们评估了所有CD44家族蛋白在胃癌（GC）中的临床和预后作用。在PubMed上检索截至2014年8月发表的文献。在37项符合条件的研究（6606例患者）中，34项纳入荟萃分析，10项进行叙述性综述。通过荟萃分析，标准CD44（CD44s）被证明可预测胃癌患者总生存期（OS）降低（HR = 1.93，95%CI：1.58 - 2.34，PHR = 0.0222）和无病生存期降低（HR = 3.13，95%CI：1.02 - 9.68，PHR = 0.0469），以及晚期N分期（RR = 1.12，95%CI：1.04 - 1.21，PRR = 0.0019）和远处转移（RR = 2.14，95%CI：1.46 - 3.14，PRR < 0.0001）。胃癌中的CD44变体6（CD44v6）可能影响总生存期（5项研究；HR = 1.27，95%CI：0.75 - 2.14，PHR = 0.3783；4项研究；HR = 1.52，95%CI：1.09 - 2.14，PHR = 0.0139），同时与疾病的N分期（RR = 1.23，95%CI：1.03 - 1.48，PRR = 0.0240）、M分期（RR = 2.54，95%CI：1.08 - 6.00，PRR = 0.0333）、TNM分期（RR = 1.72，95%CI：1.18 - 2.50，PRR = 0.0045）、Lauren分型（RR = 0.67，95%CI：0.50 - 0.91，PRR = 0.0106）、淋巴管浸润（RR = 1.13，95%CI：1.04 - 1.23，PRR = 0.0057）和肝转移（RR = 3.20，9%CI：1.94 - 5.27，PRR < 0.0001）显著相关。此外，对胃癌中的CD44亚型，如v3、v5、v7、v8 - v10和v9进行了叙述性综述。总之，通过免疫组织化学评估的CD44s和CD44v6分别可预测胃癌的预后和疾病严重程度。
