HER2 discordance between paired primary gastric cancer and metastasis: a meta-analysis
HER2 discordance between paired primary gastric cancer and metastasis: a meta-analysis
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配对原发性胃癌和转移瘤之间 HER2 的不一致：一项荟萃分析
DOI：
10.3978/j.issn.1000-9604.2014.12.09
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发表时间：
2015-04-01
影响因子：
5.1
通讯作者：
Shen, Lin
中科院分区：
文献类型：
--
作者：
Peng, Zhi;Zou, Jianling;Shen, Lin
背景：许多研究检查了原发性胃癌 (GC) 和相关转移中人表皮生长因子受体 2 (HER2) 的状态，一些研究显示 HER2 表达非常一致，但另一些研究则表现出显着的不一致。目前对于 HER2 不一致的情况仍缺乏共识，因此，我们进行了系统回顾和荟萃分析，以评估原发性 GC 与其配对转移灶之间 HER2 不一致的状况。 方法：检索 PubMed、EMBASE、ASCO 和 The Cochrane Library 探索截至 2014 年 3 月 10 日 GC 患者原发肿瘤与转移灶之间一致性的研究。 原发性 GC 与配对转移灶之间 HER2 不一致的数据从出版物中提取GC和相应的转移，并使用随机效应模型来估计汇总的不一致比例。结果：根据选择标准，纳入18篇文章（包括1,867名患者）进行荟萃分析。 HER2 状态的汇总不一致比例为 7% [95% 置信区间 (CI)：5-10%]。肿瘤从阳性转变为阴性以及从阴性转变为阳性的汇总比例分别为 17% (95% CI: 7-29%) 和 4% (95% CI: 2-6%)。荟萃分析未发现发表偏倚。结论：通过我们的荟萃分析，HER2 状态不一致在原发性和转移性 GC 中并不罕见。需要前瞻性研究来证明 HER2 状态不一致的临床意义。
Background: A number of studies have examined human epidermal growth factor receptor 2 (HER2) status in primary gastric cancer (GC) and associated metastasis, some showed their great concordance in HER2 expression, but others demonstrated notable discordance. There is still little consensus on HER2 discordance, therefore, a systematic review and meta-analysis was conducted to assess the status on HER2 discordance between primary GC and its paired metastasis.Methods: PubMed, EMBASE, ASCO and The Cochrane Library were searched for studies that explored the concordance between primary tumor and metastasis in patients with GC up to 10 March, 2014. Data of discordance of HER2 between primary GC and corresponding metastasis were extracted from the publications and random-effects models were used to estimate pooled discordance proportions.Results: Eighteen articles including 1,867 patients were included for the meta-analysis in accordance with the selection criteria. Pooled discordance proportions were 7% [95% confidence interval (CI): 5-10%] for HER2 status. Pooled proportions of tumors shifting from positive to negative and from negative to positive were 17% (95% CI: 7-29%) and 4% (95% CI: 2-6%) respectively. No publication bias was found in the meta-analysis.Conclusions: The discordance of HER2 status is not rare in primary and metastatic GC through our meta-analysis. Prospective studies are needed to testify the clinical significance of the discordance of HER2 status.