Department of Neurosurgery, Liuzhou People's Hospital, Liuzhou 545006, China.
Department of Rheumatism and Immunology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China.
Biosci Rep. 2020 Apr 30;40(4). doi: 10.1042/BSR20200520.
Higher tumor expression of CD44, a marker of cancer stem cells (CSCs), is associated with poor overall survival (OS) in various cancers. However, the association between CD44 and poor OS remains inconsistent in glioma. We aimed to evaluate the potential predictive role of CD44 for prognosis of glioma patients in a meta-analysis.
Observational studies comparing OS of glioma patients according to the level of CD44 were identified through searching PubMed, Embase, and Cochrane's Library databases. Meta-analyses were performed with a random- or fixed-effect model according to the heterogeneity. Subgroup analyses were performed to evaluate the influences of study characteristics.
Eleven retrospective cohort studies were included. Results showed that increased CD44 expression in tumor predicted poor OS in glioma patients (hazard ratio [HR]: 1.42, 95% confidence interval [CI]: 1.02-1.97, P=0.04). Subgroup analyses showed that higher tumor CD44 expression significantly predicted poor OS in patients with World Health Organization (WHO) stages II-III glioma (HR: 2.99, 95% CI: 1.53-5.89, P=0.002), but not in patients with glioblastoma (HR: 1.26, 95% CI: 0.76-2.08, P=0.47; P for subgroup difference = 0.03). Results were not statistically different between subgroups according to patient ethnicity, sample size, CD44 detection method, CD44 cutoff, HR estimation, univariate or multivariate analysis, or median follow-up durations (P-values for subgroup difference all >0.10).
Higher tumor expression of CD44 may predict poor survival in patients with glioma, particularly in those with WHO stage II-III glioma.
CD44 是癌症干细胞 (CSC) 的标志物，其在肿瘤中的高表达与多种癌症的总生存期 (OS) 不良相关。然而，CD44 与胶质瘤患者 OS 不良之间的关联仍不一致。我们旨在通过荟萃分析评估 CD44 对胶质瘤患者预后的潜在预测作用。
通过检索 PubMed、Embase 和 Cochrane 图书馆数据库，确定了比较 CD44 水平与胶质瘤患者 OS 的观察性研究。根据异质性，采用随机或固定效应模型进行荟萃分析。进行亚组分析以评估研究特征的影响。
纳入了 11 项回顾性队列研究。结果表明，肿瘤中 CD44 表达增加预示着胶质瘤患者 OS 不良（风险比 [HR]：1.42，95%置信区间 [CI]：1.02-1.97，P=0.04）。亚组分析表明，较高的肿瘤 CD44 表达显著预测了 WHO 分级 II-III 级胶质瘤患者的不良 OS（HR：2.99，95% CI：1.53-5.89，P=0.002），但对胶质母细胞瘤患者则不然（HR：1.26，95% CI：0.76-2.08，P=0.47；P 亚组差异=0.03）。根据患者种族、样本量、CD44 检测方法、CD44 截断值、HR 估计、单变量或多变量分析或中位随访时间，亚组之间的结果无统计学差异（P 亚组差异均>0.10）。
肿瘤中 CD44 的高表达可能预示着胶质瘤患者的生存不良，特别是在 WHO 分级 II-III 级胶质瘤患者中。
