CD44 的阳性表达与肝细胞癌患者生存预后结果的Meta 分析

Correlation between the expression of CD44 and poor survival prognosis in hepatocellular carcinoma: a meta-analysis

摘要:

目的 探索肿瘤标志物CD44 与肝细胞癌临床病理特点及肝细胞癌患者生存预后之间的联系。方法检索PubMed，EMbase 和Cochrane 图书馆数据库，截止日期为2017 年8 月2 日。采用STATA 软件对肿瘤细胞CD44 的阳性表达与肝癌的肿瘤临床分期，肿瘤分级，甲胎蛋白等临床病理特征，及CD44 阳性表达与肝癌患者生存预后结果包括总生存率（OS）和无病生存率（DFS）之间进行荟萃分析。结果 10 篇文章符合纳入标准，共对 1 620 例患者进行荟萃分析。CD44 的阳性表达与肝癌患者的临床分期（O^^R=1.41，95%CI ：1.02，1.93），及肿瘤分级（O^^R=1.29，95%CI：1.02，1.62），差异有统计学意义，然而CD44阳性表达与肝癌患者甲胎蛋白水平 高低、乙肝病毒感染、血管侵犯及肿瘤大小等差异无统计学意义；CD44 阳性表达与肝癌患者生存预后密切相关，包括总生存率（R^^R=1.44，95%CI：1.29，1.61），无病生存率（R^^R=1.45，95%CI：1.30，1.61），差异有统计学意义。结论 CD44 阳性表达与肝癌患者预后不良密切相关。

Abstract:

Objective To proceed a meta-analysis to investigate the relationship among the CD44 overexpression, clinicopathological significance and prognostic importance in hepatocellular carcinoma. Methods Relevant articles retrieved from PubMed, EMBASE, the Cochrane Library, which were published before the deadline of August 2017, were included. The pathologic characteristics of hepatocellular carcinoma and overall survival (OS) and the disease-free survival (DFS) rates were determined with Stata statistical software, version 12.0. Results Our study suggested that the positive expression of CD44 was meaningfully correlated with a poor pathology grading (O^^R =1.2, 95% CI: 1.02, 1.62, Random-effect) and advanced stage of carcinoma (O^^R = 1.4, 95% CI: 1.02, 1.93, Randomeffect).While CD44 had no significant correlation with hepatitis, cirrhosis, the high level of AFP, and tumor size. Additionally, the overexpression of CD44 was significantly correlated with worse survival outcomes, including OS(R^^R = 1.44, 95% CI: 1.29, 1.61) and DFS (R^^R = 1.45, 95% CI: 1.30, 1.61). Conclusion Over-expression CD44 is significantly associated with clinicopathological features and worse survival prognosis.