Abstract
Various literatures have demonstrated that overexpression of Metadherin (MTDH) is correlated with tumor metastasis and it can predict poor survival outcomes in female reproduction malignancies. In order to enhance the statistical power and reach a recognized conclusion, we conducted a systematic review and meta-analysis to thoroughly investigate the association of MTDH expression with tumor metastasis and survival outcomes following PRISMA guidelines. Odds ratios (ORs) and hazard ratios (HRs) were used to demonstrate the impact of MTDH on tumor metastasis and prognosis respectively. Data were pooled with appropriate effects model on STATA12.0. Our results indicated that high MTDH expression is significantly correlated with higher mortality for breast, ovarian and cervical cancer. High immunohistochemical expression of MTDH is remarkably associated with shorter disease-free survival (DFS) in breast cancer but not in ovarian cancer. The pooled results suggested that high level of MTDH significantly predicted distant metastasis and lymph node metastasis in breast cancer. Strong associations were observed between MTDH expression and lymph node metastasis in ovarian and cervical cancer. In conclusion, MTDH might be a novel biomarker which can effectively reflect metastasis status and prognosis of breast cancer. However, its application in clinical practice needs more prospective studies with large samples.
Highlights
Reproduction malignancies, including breast cancer, cervical cancer, ovarian cancer and endometrial cancer, have been one of the major causes of death in females, among which, breast cancer is the most common malignancy and the leading cause of cancer death in western countries
As several studies have regarded MTDH as the potential biomarker which can indicate the metastasis and prognosis in malignancies, and as MTDH could miraculously induce breast cancer cells transferring to lung in mouse model, we carried out this comprehensive systematic review and meta-analysis based on published literature to thoroughly investigate the significance of MTDH in reproduction malignancies
Our results showed that MTDH, as a cell surface protein, is significantly associated with the mortality of patients with reproduction malignancies (HR = 3.647), including breast cancer (HR = 2.728), ovarian cancer (HR = 4.525), cervical cancer (HR = 2.524) and endometrial cancer (HR = 2.524)
Summary
Reproduction malignancies, including breast cancer, cervical cancer, ovarian cancer and endometrial cancer, have been one of the major causes of death in females, among which, breast cancer is the most common malignancy and the leading cause of cancer death in western countries. Nowadays medical treatment is advanced, the prognosis of reproduction malignancies patients is dismal, and metastasis is still the major cause of death. Two authors have performed meta-analysis to evaluate the clinicopathological and prognostic role of MTDH in squamous cell carcinoma and gastrointestinal cancers respectively. They concluded that high MTDH expression was remarkably correlated with lymph node metastasis, distant metastasis and short OS9,10. By reviewing published literature we performed a comprehensive meta-analysis in order to get a consistent and reliable conclusion and to cast light on the impact of MTDH expression on metastasis and survival status
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