Abstract
Numbers of clinical and experimental investigations have provided increasing evidences to demonstrate that heat shock protein 27 (HSP27) is a qualified predictor for many cancers. However, no consensus has been reached on its clinicopathological and prognostic significance in patients with non-small cell lung cancer (NSCLC). Therefore, we performed this systematic meta-analysis to help addressing this issue. PubMed, EMBASE, the Web of Science and China National Knowledge Infrastructure were searched for full-text literatures met out eligibility criteria. We determined the odds ratio (OR) and hazard ratio (HR) as the appropriate summarized statistics for assessments of clinicopathological and prognostic roles of HSP27, respectively. Q-test and I2-statistic were used to evaluate the level of heterogeneity. Sensitivity analysis was conducted to examine the stability of overall estimates. Potential publication bias was detected by Begg’s test and Egger’s test. Finally, ten articles were identified to be included into our meta-analysis. The pooled analyses suggested that HSP27 expression was significantly associated with the unfavorable conditions for differentiation degree, lymphatic metastasis, clinical stage, squamous cell carcinoma and tumor size. However, HSP27 expression had no significant relationship to gender, age and smoking status. Meanwhile, pooled HRs indicated that HSP27 expression could be a predictor for a lower 5-year overall survival (OS) rate (HR: 1.832; 95 % CI 1.322–2.538; P < 0.001) but not for 1-year OS of NSCLC (HR: 0.885; 95 % CI 0.140–5.599; P = 0.896). In conclusion, our meta-analysis demonstrates that HSP27 expression may be a strong biomarker to predict both the poor clinicopathological and prognostic characteristics in patients with NSCLC.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-2827-8) contains supplementary material, which is available to authorized users.
Highlights
Lung cancer is the leading cause of malignancy-related death around the world
The initial filtration was based on screening the titles and abstracts, while further filtration was conducted by reading through the full-text of remaining literatures
Our meta-analysis showed that heat shock protein 27 (HSP27) expression was significantly associated with worse pathological characteristics of Nonsmall cell lung cancer (NSCLC), including poor differentiation degree, lymphatic metastasis, advanced TNM stage, SCC and larger tumor size
Summary
Lung cancer is the leading cause of malignancy-related death around the world. Nonsmall cell lung cancer (NSCLC) accounts for more than 85 % of all lung cancer cases and its five-year overall survival (OS) rate approximates 15 % in both developed and developing countries (Jemal et al 2011; Alberg et al 2013; Efird et al 2014). According to WHO’s estimations, China will become one of the countries with relatively higher prevalence of NSCLC in this century. Early metastasis and poor response to treatments are the potential leading causes for a poor prognosis of NSCLC. To improve clinicians’ decisions on appropriate therapeutic regimens and patient managements, it has been increasingly urgent to identify strong biomarkers that can accurately predict the clinicopathological characteristics and prognostic outcomes of NSCLC
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