Yan Qingying, Guo Kaibo, Feng Guan, Shan Feiyu, Sun Leitao, Zhang Kai, Shen Fengfei, Shen Minhe, Ruan Shanming
The First Clinical Medical College of Zhejiang Chinese Medical University Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou Department of Traditional Chinese Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Medicine (Baltimore). 2018 Sep;97(37):e12317. doi: 10.1097/MD.0000000000012317.
This study aimed to investigate the association between the overexpression of human epidermal growth factor receptor-3 (Her3) and the clinicopathological parameters and survival of patients with colorectal cancer (CRC).
Relevant studies on the overexpression of Her3 (measured by immunohistochemistry) and overall survival (OS) in patients with CRC were searched for in PubMed, EMBASE, and Cochrane Library. Published data were extracted and computed into odds ratios (ORs) for assessing the association of Her3 overexpression with tumor differentiation, tumor node metastasis (TNM) stage, position of colon cancer, sex, and age. Prognostic data were computed into hazard ratios (HRs) for OS.
Eight studies including 1716 patients with CRC were included in this meta-analysis. The results revealed a significant association between Her3 overexpression and tumor differentiation [OR = 2.38; 95% confidence interval (95% CI): 1.76-3.22; P < .001], TNM tumor stage (OR = 0.71; 95% CI: 0.53-0.96; P = .03), and position of colon cancer (OR = 1.71; 95% CI: 1.28-2.27; P < .001). While patients with Her3 overexpression demonstrated a worse tumor response (OR = 0.31; 95% CI: 0.16-0.60; P < .001) and OS after treatment with cetuximab (HR = 1.86; 95% CI: 1.24-2.79; P = .003), they demonstrated better OS after symptomatic treatment (HR = 0.65; 95% CI: 0.50-0.85; P = .002). Her3 overexpression was not associated with sex (OR = 1.03; 95% CI: 0.83-1.28; P = .79), age (OR = 0.96; 95% CI: 0.75-1.24; P = .77), colon or rectum site (OR = 0.79; 95% CI: 0.44-1.43; P = .44), and total OS (HR = 1.09; 95% CI: 0.69-1.72; P = .72).
Her3 expression is associated with the clinical pathology and prognosis of CRC, which explains the nonefficacy of cetuximab treatment in patients with CRC.
本研究旨在探讨人表皮生长因子受体-3（Her3）过表达与结直肠癌（CRC）患者临床病理参数及生存情况之间的关联。
在PubMed、EMBASE和Cochrane图书馆中检索关于CRC患者Her3过表达（通过免疫组织化学检测）及总生存期（OS）的相关研究。提取已发表的数据并计算比值比（OR），以评估Her3过表达与肿瘤分化、肿瘤淋巴结转移（TNM）分期、结肠癌位置、性别和年龄之间的关联。将预后数据计算为OS的风险比（HR）。
本荟萃分析纳入了8项研究，共1716例CRC患者。结果显示，Her3过表达与肿瘤分化[OR = 2.38；95%置信区间（95%CI）：1.76 - 3.22；P <.001]、TNM肿瘤分期（OR = 0.71；95%CI：0.53 - 0.96；P =.03）和结肠癌位置（OR = 1.71；95%CI：1.28 - 2.27；P <.001）之间存在显著关联。虽然Her3过表达的患者在接受西妥昔单抗治疗后显示出较差的肿瘤反应（OR = 0.31；95%CI：0.16 - 0.60；P <.001）和OS（HR = 1.86；95%CI：1.24 - 2.79；P =.003），但在对症治疗后显示出较好的OS（HR = 0.65；95%CI：0.50 - 0.85；P =.002）。Her3过表达与性别（OR = 1.03；95%CI：0.83 - 1.28；P =.79）、年龄（OR = 0.96；95%CI：0.75 - 1.24；P =.77）、结肠或直肠部位（OR = 0.79；95%CI：0.44 - 1.43；P =.44）以及总OS（HR = 1.09；95%CI：0.69 - 1.72；P =.72）无关。
Her3表达与CRC的临床病理及预后相关，这解释了西妥昔单抗治疗CRC患者无效的原因。
