Abstract
BackgroundIn this study, using a meta-analysis approach, we examined the correlation between serum levels of lysophosphastidic acid (LPA) and ovarian cancer (OC).MethodsRelevant published studies were identified from multiple scientific literature databases by using a pre-determined electronic and manual search strategy. The search results were screened through a multi-step process to select high-quality case–control studies suitable for the present meta-analysis. Mean values and standardized mean differences (SMD) were calculated for plasma LPA levels. Two investigators independently extracted the data from the studies and performed data analysis using STATA software version 12.0 (Stata Corp, College Station, TX, USA).ResultsNineteen case–control studies met our selection criteria and contained a total of 980 OC patients, 872 benign controls and 668 healthy controls. Our meta-analysis results revealed that the plasma levels of LPA in OC patients were significantly higher than benign controls (SMD = 2.36, 95 % CI: 1.61–3.10, P <0.001) and healthy controls (SMD = 2.32, 95 % CI: 1.77–2.87, P <0.001). Subgroup analysis by ethnicity showed that the plasma LPA levels in OC patients were significantly higher than the benign controls only in Asian populations (SMD = 2.52, 95 % CI: 1.79–3.25, P <0.001). However, a comparison between healthy controls and OC patients revealed that, in both Asians and Caucasians, the OC patients displayed significantly higher plasma LPA levels compared to healthy controls (all P <0.05).ConclusionOur meta-analysis showed strong evidence that a significantly higher plasma LPA levels are present in OC patients, compared to benign controls and healthy controls, and plasma LPA levels may be used as a biomarker or target of OC.
Highlights
Ovarian cancer (OC) is the deadliest among gynecological cancers, with 5-year survival rates ranging between 30-50 %
Consistent with this, plasma levels of lysophosphastidic acid (LPA) are strongly associated with presence of ovarian tumors and plasma levels of LPA are significantly higher in ovarian cancer (OC) patients compared to benign ovarian lesions [4, 11]
Study selection The inclusion criteria for selection of published studies for this meta-analysis were: (1) OC patients must be confirmed by pathological diagnosis; (2) study design must be case–control studies reporting the correlation between plasma LPA levels and OC; (3) the plasma LPA levels and sample size must be supplied; (4) published studies with full text
Summary
Ovarian cancer (OC) is the deadliest among gynecological cancers, with 5-year survival rates ranging between 30-50 %. LPA mediated pathways are prominently linked to tumor growth and metastasis in various cancers and significant efforts are underway to understand the precise role of LPA and design effective intervention strategies. LPA is converted from lysophospholipids in the serum and plasma, and from phosphatidic acid in platelets and cancer cells [8]. Previous studies showed that increased LPA levels are closely associated with the elevated expression levels of other prominent metastasis promoters critical for OC progression [12, 13]. Perhaps due to the complexity of the LPA pathway and the diversity of its receptors, several other studies reported results contradicting the links between LPA and ovarian cancer [14, 15]. In this study, using a meta-analysis approach, we examined the correlation between serum levels of lysophosphastidic acid (LPA) and ovarian cancer (OC)
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