CD133 overexpression correlates with clinicopathological features of gastric cancer patients and its impact on survival: A systematic review and meta-analysis
CD133 overexpression correlates with clinicopathological features of gastric cancer patients and its impact on survival: A systematic review and meta-analysis
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CD133过表达与胃癌患者的临床病理特征及其对生存的影响相关：系统评价和荟萃分析
DOI：
10.18632/oncotarget.5714
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发表时间：
2015-12-08
期刊：
影响因子：
--
通讯作者：
Chen Zhinan
中科院分区：
文献类型：
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作者：
Li Yiming;Guo Yunshan;Chen Zhinan
背景资料：CD 133是肿瘤干细胞（cancer stem cells，CSC）最常用的标志物之一，具有自我更新和致瘤能力。然而，CD 133在胃癌中的临床和预后意义仍存在争议。为了明确CD 133的临床意义，我们进行了一项系统回顾和荟萃分析，以阐明CD 133过表达与胃癌患者预后和临床病理特征的相关性。方法：检索科克伦图书馆、Pubmed、Medline、Web of Knowledge和中国知网、CBM（截至2015年6月30日）使用以下关键词胃癌、CD 133、AC 133、Escherin-1等进行电子检索，并通过手动检索参考文献列表、摘要和会议记录进行补充。结果包括总生存率和各种临床病理特征。由2名评价者按照纳入和排除标准独立筛选文献，提取数据，并对纳入研究的方法学质量进行评价，然后采用RevMan 5.2.0软件进行Meta分析。荟萃分析结果显示，在以下比较中，CD 133表达存在显著差异：胃癌组织与正常食管组织（OR = 3.49，95%CI [2.48，490]，P < 0.00001），淋巴结转移vs.非淋巴结转移（OR = 2.75，95%CI [1.99，3.81]，P < 0.00001），远处转移vs.非远处转移（OR = 2.38，95% CI [1.47，3.85]，P < 0.0004），临床分期III与IV相似，临床分期I与II相似（OR = 2.83，95%CI [2.13，3.76]，P < 0.00001），以及CD 133阳性与CD 133阴性患者的累积5年总生存率OR = 0.23，95% CI [0.16，0.33]，P < 0.00001。此外，CD 133阳性的胃癌患者预后较差。结果提示，CD 133可能参与了胃癌的发生发展。评估细胞质CD 133过表达的胃癌组织切片可能是有用的，在未来作为一种新的预后因素。但由于纳入试验的质量差、样本量小，需要开展更多设计良好的多中心随机对照试验。
Background: CD133 is one of the most commonly used markers of cancer stem cells (CSCs), which are characterized by their ability for self-renewal and tumorigenicity. However, the clinical and prognostic significance of CD133 in gastric cancer remains controversial. To clarify a precise determinant of the clinical significance of CD133, we conducted a systematic review and meta-analysis to elucidate the correlation of CD133 overexpression with prognosis and clinicopathological features of GC patients.Methods: A search in the Cochrane Library, Pubmed, Medline, Web of Knowledge and Chinese CNKI, CBM (up to Jun 30, 2015) was performed using the following keywords gastric cancer, CD133, AC133, prominin-1, etc. Electronic searches were supplemented by hand searching reference lists, abstracts and proceedings from meetings. Outcomes included overall survival and various clinicopathological features. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies, and then RevMan 5.2.0 software was used for meta-analysis.Results: A total of 603 gastric cancer patients from 8 studies were included. The results of the meta-analyses showed that, there were significant differences of CD133 expression in the following comparisons: gastric cancer tissues vs. normal esophageal tissue (OR = 3.49, 95% CI [2.48, 490], P < 0.00001), lymph node metastasis vs. non-lymph node metastasis (OR = 2.75, 95% CI [1.99, 3.81], P < 0.00001), distant metastasis vs. non-distant metastasis (OR = 2.38, 95% CI [1.47, 3.85], P < 0.0004), clinical stages III similar to IV vs. clinical stages I similar to II (OR = 2.83, 95% CI [2.13, 3.76], P < 0.00001), as well as the accumulative 5-year overall survival rates of CD133-positive vs. CD133-negative patients (OR = 0.23, 95% CI [0.16, 0.33], P < 0.00001).Conclusion: Overexpression of CD133 is associated with lymph node metastasis, distant metastasis, poor TNM stage. Additionally, CD133-positive gastric cancer patients had worse prognosis. Our results indicate that CD133 may be involved in the carcinogenesis of gastric cancer. Evaluation of cytoplasmic CD133 overexpression in gastric cancer tissue sections may be useful in the future as a novel prognostic factor. Nevertheless, due to the poor quality and small sample size of included trials, more well-designed multi-center randomized controlled trials should be performed.