Medical Centre for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.
PLoS One. 2021 Mar 31;16(3):e0249040. doi: 10.1371/journal.pone.0249040. eCollection 2021.
GPRC5A is associated with various cancer initiation and progression. Controversial findings have been reported about GPRC5A prognostic characteristics, and no meta-analysis has been conducted to assess the relationship between GPRC5A and cancer prognosis. Therefore, the objective of this meta-analysis is to evaluate the overall prognostic effectiveness of GPRC5A.
We first conducted a systematic search in the PubMed, Embase, Web of Science, CNKI, Cochrane, and WangFang databases. The hazard ratio (HR) and odds ratios (OR) with 95% CI were then pooled to assess the associations between GPRC5A expression and overall survival (OS), disease-free survival (DFS), event-free survival (EFS), and clinicopathological characteristics. Chi-squared test and I2 statistics were completed to evaluate the heterogeneity in our study. A random-effects model was used when significant heterogeneity existed (I2>50% and p<0.05); otherwise, we chose the fixed-effect model. Subgroup analysis was stratified by tumor type, region, HR obtained measurements, and sample capacity to explore the source of heterogeneity.
In total, 15 studies with 624 patients met inclusion criteria of this study. Our results showed that higher expression of GPRC5A is associated with worse OS (HR:1.69 95%CI: 1.20-2.38 I2 = 75.6% p = 0.000), as well as worse EFS (HR:1.45 95%CI: 1.02-1.95 I2 = 0.0% p = 0.354). Subgroup analysis indicated that tumor type might be the source of high heterogeneity. Additionally, cancer patients with enhanced GPRC5A expression were more likely to lymph node metastasis (OR:1.95, 95%CI 1.33-2.86, I2 = 43.9%, p = 0.129) and advanced tumor stage (OR: 1.83, 95%CI 1.15-2.92, I2 = 61.3%, p = 0.035), but not associated with age, sex, differentiation, and distant metastasis.
GPRC5A can be a promising candidate for predicting medical outcomes and used for accurate diagnosis, prognosis prediction for patients with cancer; however, the predictive value of GPRC5A varies significantly according to cancer type. Further studies for this mechanism will be necessary to reveal novel insights into application of GPRC5A in cancers.
GPRC5A 与各种癌症的发生和进展有关。关于 GPRC5A 的预后特征，已有报道存在争议，并且尚未进行荟萃分析来评估 GPRC5A 与癌症预后之间的关系。因此，本荟萃分析的目的是评估 GPRC5A 的总体预后效果。
我们首先在 PubMed、Embase、Web of Science、CNKI、Cochrane 和万方数据库中进行了系统搜索。然后，使用风险比（HR）和优势比（OR）及其 95%置信区间（CI）来评估 GPRC5A 表达与总生存期（OS）、无病生存期（DFS）、无事件生存期（EFS）和临床病理特征之间的关系。我们完成了卡方检验和 I2 统计来评估研究中的异质性。如果存在显著异质性（I2>50%且 p<0.05），则使用随机效应模型；否则，我们选择固定效应模型。通过肿瘤类型、区域、获得的 HR 测量值和样本量进行亚组分析，以探索异质性的来源。
共有 15 项研究，涉及 624 名患者，符合本研究的纳入标准。我们的结果表明，GPRC5A 的高表达与较差的 OS（HR：1.69，95%CI：1.20-2.38 I2 = 75.6%，p = 0.000）和较差的 EFS（HR：1.45，95%CI：1.02-1.95 I2 = 0.0%，p = 0.354）有关。亚组分析表明，肿瘤类型可能是高异质性的来源。此外，GPRC5A 表达增强的癌症患者更有可能发生淋巴结转移（OR：1.95，95%CI 1.33-2.86，I2 = 43.9%，p = 0.129）和晚期肿瘤分期（OR：1.83，95%CI 1.15-2.92，I2 = 61.3%，p = 0.035），但与年龄、性别、分化和远处转移无关。
GPRC5A 可以成为预测癌症患者治疗效果的有前途的候选标志物，并用于癌症的准确诊断和预后预测；然而，GPRC5A 的预测价值因癌症类型而异。需要进一步的研究来揭示 GPRC5A 在癌症中的应用的新见解。
