Clinical and Prognostic Implications of (WAF1/CIP1) Expression in Patients with Esophageal Cancer: A Systematic Review and Meta-Analysis.

BACKGROUND

Previous studies have demonstrated that (WAF1/CIP1) is a valuable prognostic factor in several malignant tumors. However, it is not known whether can predict the prognosis in patients with esophageal cancer (EC). The aim of this research was to investigate the contribution of expression to the clinicopathological characteristics and of EC.

METHODS

A systematic review and meta-analysis of study focusing on expression, clinicopathological characteristics, and clinical outcomes in patients with EC was performed using seven databases (PubMed, Embase, Web of Science, and four Chinese databases). Pooled hazard ratios and odds ratios were used to explore the association between expression, clinicopathological characteristics, and outcomes in patients with EC. The heterogeneity of the studies was classified by the statistic. The sensitivity analysis was then utilized to assess the robustness of the results. Finally, the funnel plot and Begg's test were used to evaluate the publication bias.

RESULTS

Forty-five studies with 3098 patients were eligible for inclusion in the meta-analysis. Thirty of these studies reported on clinicopathological characteristics and 15 on clinical outcomes. The pooled hazard ratio of 1.456 (95% confidence intervals 1.033-2.053, = 0.032) for overall survival indicated that a low expression level was an unfavorable prognostic factor for a clinical outcome in patients with EC. Furthermore, the pooled odds ratio confirmed an association between decreased expression and poor clinicopathological characteristics, including differentiation, lymph node metastasis, invasion, and higher grade and clinical stage. Notably, high expression was a significant predictor of a favorable response to chemotherapy. There was no evidence of publication bias.

CONCLUSION

Reduced expression is associated with a poor outcome in patients with EC.