Abstract
Aim A meta-analysis was conducted to estimate the impact of connective tissue growth factor (CTGF) on outcomes in patients with digestive system cancers. Methods A systemic literature survey was performed by searching the Cochrane Library and PubMed databases for articles that evaluated the impact of CTGF on outcomes in patients with digestive system cancers. Hazard ratios and 95% confidence intervals were calculated for prognostic factors, overall and recurrence-free survival using RevMan 5.3 software. Results This meta-analysis was conducted to evaluate a total of 11 studies that included 1730 patients. The results showed that elevated CTGF expression was significantly correlated with advanced age, larger tumor size, multiple tumors, and vascular invasion. Subgroup analysis by cancer type revealed increased risk for lymph node metastasis and advanced tumor node metastasis (TNM) stage in gastric cancer, compared with colorectal cancer. An unfavorable effect of elevated CTGF levels on overall survival was found in patients with hepatocellular carcinoma and patients with gastric cancer, while survival was improved in colorectal cancer patients with high CTGF expression, compared to those with normal levels of CTGF. Conclusions Elevated CTGF expression may be a novel biomarker for disease status and predicted survival outcomes in patients with specific digestive system cancers.
Highlights
Cancer of the digestive system is one of the leading causes of cancer-related death worldwide [1]
The results showed that the overexpression of Connective tissue growth factor (CTGF) was associated with increased risk for lymph node metastasis (OR = 2:68, 95% confidence intervals (CI): 1.54-4.68) and advanced tumor node metastasis (TNM) stage (OR = 1:95, 95% CI: 1.19-3.19) in gastric cancer (GC)
In colorectal cancer (CRC), elevated CTGF expression was associated with decreased risk for lymph node metastasis (OR = 0:44, 95% CI: 0.27-0.73) and lower TNM stage (OR = 0:45, 95% CI: 0.27-0.76) (Figure 3)
Summary
Cancer of the digestive system is one of the leading causes of cancer-related death worldwide [1]. There have been great advances in surgical techniques and postoperative therapy, patients with these cancers have poor clinical prognosis due to advanced-stage disease or tumor metastasis [5,6,7]. Previous studies have demonstrated the upregulation of CTGF in a range of human cancers with poor prognosis, some studies reported conflicting results [12,13,14,15,16]. The role that CTGF plays in the diagnosis and prognosis of digestive system cancer remains unknown. We designed this meta-analysis to evaluate the correlation between levels of CTGF and clinical characteristics and prognosis in patients with digestive system cancers
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