Lu Li, Huang Fei, Zhao Zhicheng, Li Chuan, Liu Tong, Li Weidong, Fu Weihua
Department of General Surgery, Tianjin Medical University General Hospital, Heping District, Tianjin, China.
Medicine (Baltimore). 2016 Dec;95(50):e5603. doi: 10.1097/MD.0000000000005603.
The diagnostic and prognostic value of CD44v6 in patients with gastric cancer remains unclear. Therefore, a quantitative meta-analysis was conducted to determine the clinical value of CD44v6 in patients with gastric cancer.
Sixteen studies with 2177 patients were included. Pooled odds ratios (ORs) and hazard ratio (HR) with 95% confidence intervals (CIs) were calculated to estimate the impact of CD44v6 in patients with gastric cancer on clinicopathological features and 5-year overall survival (OS). Sensitivity analysis, subgroup analysis, and regression analysis were introduced to evaluate the heterogeneity across the studies. Publication bias was also explored among the studies.
The meta-analysis showed that the upregulated CD44v6 was associated with lymph node metastasis (OR 1.91, 95% CI 1.19-3.08; P = 0.007), distant metastasis (OR 3.41, 95% CI 2.01-5.78; P = 0.000), high TNM stage (OR 2.29, 95% CI 1.10-4.75; P = 0.026), lymphatic vessel invasion (OR 1.59, 95% CI 1.21-2.09; P = 0.001), and vascular invasion (OR 1.57, 95% CI 1.19-2.07; P = 0.001). When excluded 1 study based on sensitivity analysis, pooled HR indicated that CD44v6 positive expression was correlated poor 5-year OS (OR 1.76, 95% CI 1.30-2.39; P = 0.000), meanwhile, heterogeneity was eliminated. The heterogeneity of Lauren type mainly existed in the big sample size subgroup. Different region and publication year might contribute to the heterogeneity of differentiation type. While the heterogeneity of lymph node mainly existed in Asian and big sample size group. Publication bias was observed among 12 studies on lymph node metastasis (Ppublication bias = 0.041), and 5 studies on TNM stage (Ppublication bias = 0.026).
Taken together, CD44v6 overexpression might be correlated to the characteristics of tumor metastasis in gastric cancer, consisting with many mechanism studies. Therefore, CD44v6 might present a metastasis-associated biomarker in patients with gastric cancer.
CD44v6在胃癌患者中的诊断和预后价值仍不明确。因此，进行了一项定量荟萃分析以确定CD44v6在胃癌患者中的临床价值。
纳入了16项研究，共2177例患者。计算合并比值比（OR）和风险比（HR）以及95%置信区间（CI），以评估CD44v6在胃癌患者中对临床病理特征和5年总生存期（OS）的影响。采用敏感性分析、亚组分析和回归分析来评估各研究间的异质性。还对各研究中的发表偏倚进行了探讨。
荟萃分析显示，CD44v6上调与淋巴结转移（OR 1.91，95%CI 1.19 - 3.08；P = 0.007）、远处转移（OR 3.41，95%CI 2.01 - 5.78；P = 0.000）、高TNM分期（OR 2.29，95%CI 1.10 - 4.75；P = 0.026）、淋巴管侵犯（OR 1.59，95%CI 1.21 - 2.09；P = 0.001）和血管侵犯（OR 1.57，95%CI 1.19 - 2.07；P = 0.001）相关。基于敏感性分析排除1项研究后，合并HR表明CD44v6阳性表达与5年OS较差相关（OR 1.76，95%CI 1.30 - 2.39；P = 0.000），同时异质性被消除。Lauren分型的异质性主要存在于大样本量亚组中。不同地区和发表年份可能导致分化型的异质性。而淋巴结的异质性主要存在于亚洲和大样本量组中。在关于淋巴结转移的12项研究（P发表偏倚 = 0.041）和关于TNM分期的5项研究（P发表偏倚 = 0.026）中观察到发表偏倚。
综上所述，CD44v6过表达可能与胃癌的肿瘤转移特征相关，这与许多机制研究一致。因此，CD44v6可能是胃癌患者中一种与转移相关的生物标志物。
