Ye Yongzhi, Chen Meiqiong, Ji Fada, Mi Suicai, Chen Zhixiong, Wu Xiaowei, He Qiurong, Liu Xiaodong
Department of General Surgery, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, People's Republic of China.
Department of Operation Management, Women and Children's Hosipital, School and Medicine, Xiamen University, Xiamen, People's Republic of China.
Cancer Rep (Hoboken). 2025 Aug;8(8):e70296. doi: 10.1002/cnr2.70296.
High expression levels of cluster of differentiation 47 (CD47) have been recognized as poor survival in several different cancers. Nevertheless, the significance of CD47 in patients with solid tumors remains controversial.
The objective of this study is to elucidate whether elevated CD47 expression independently predicts a poor prognosis across solid tumors through pooled survival and clinicopathological analyses.
This meta-analysis was based on a search of PubMed, Embase, and Web of Science databases to obtain 20 eligible published studies (totaling 4019 patients) between January 2018 and January 2024. The combined hazard ratios (HRs) for overall survival (OS) were evaluated, and the HRs for relapse-free survival (RFS), progression-free survival (PFS), and disease-free survival (DFS), as well as odds ratios for clinicopathological data, were also respectively combined. The data obtained from these studies were extracted from these published studies and analyzed. This study suggested that CD47 overexpression was related to shorter OS times in human solid tumors, with a combined HR for OS (according to the univariate analysis) of HR = 1.63 (95% confidence intervals,[ 95% CIs]: 1.45-1.83; p < 0.00001), and a pooled HR for OS (according to the multivariate analysis) of HR = 2.02 (95% CI: 1.43-2.84; p < 0.0001). The subgroup analysis revealed that CD47 overexpression was related to inferior OS rates according to country, cancer type, sample size, analysis type, and the method via which the HR value was obtained (i.e., reported or extracted; p < 0.05); in addition, a high expression level of CD47 was also a predictor of poor DFS, PFS, and RFS rates (p < 0.00001). Certain factors, such as age (≥ 60 years old), lymph node metastasis, TNM staging, differentiation type, and tumor recurrence, resulted in an upregulation of CD47 (p < 0.05).
This meta-analysis indicates that CD47 overexpression is significantly associated with poor clinical outcomes, advanced clinical stages, and poor differentiation in solid tumor patients, particularly, in cases involving tumors in the digestive and respiratory systems. These findings suggest that CD47 could serve as a valuable prognostic biomarker and therapeutic target.
分化簇47（CD47）的高表达水平在几种不同癌症中被认为与生存率低相关。然而，CD47在实体瘤患者中的意义仍存在争议。
本研究的目的是通过汇总生存分析和临床病理分析，阐明CD47表达升高是否能独立预测实体瘤患者的不良预后。
本荟萃分析基于对PubMed、Embase和Web of Science数据库的检索，以获取2018年1月至2024年1月期间20项符合条件的已发表研究（共4019例患者）。评估总生存（OS）的合并风险比（HR），并分别合并无复发生存（RFS）、无进展生存（PFS）和无病生存（DFS）的HR以及临床病理数据的比值比。从这些已发表研究中提取并分析所获得的数据。本研究表明，CD47过表达与人类实体瘤较短的OS时间相关，OS的合并HR（根据单变量分析）为HR = 1.63（95%置信区间，[95%CI]：1.45 - 1.83；p < 0.00001），OS的汇总HR（根据多变量分析）为HR = 2.02（95%CI：1.43 - 2.84；p < 0.0001）。亚组分析显示，根据国家、癌症类型、样本量、分析类型以及获得HR值的方法（即报告或提取；p < 0.05），CD47过表达与较差的OS率相关；此外，CD47高表达水平也是DFS、PFS和RFS率较差的预测指标（p < 0.00001）。某些因素，如年龄（≥60岁）、淋巴结转移、TNM分期、分化类型和肿瘤复发，导致CD47上调（p < 0.05）。
本荟萃分析表明，CD47过表达与实体瘤患者的不良临床结局、晚期临床分期和低分化显著相关，特别是在涉及消化和呼吸系统肿瘤的病例中。这些发现表明，CD47可作为一种有价值预后生物标志物和治疗靶点。
