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Abstract
BackgroundThe CSC (cancer stem cell) markers often indicate poor prognosis and more cell invasion or migration of cancer patients. Podoplanin was assumed as a candidate CSC marker and predict poor prognosis among squamous cancers. Whereas, the prognostic value of podoplanin among lung squamous cancer (LUSC) patients remains controversial.MethodsA search of databases including PubMed, Embase and Web of Science was performed. Eligible articles studying the prognostic significance of podoplanin were selected. Odds ratio and HR (hazard ratio) were used to assess the relationships between podoplanin and clinical characteristics, as well as to quantify its prognostic role. The heterogeneity was estimated by I2 Statistic and P values from sensitivity analysis. Begg’s funnel plots were used to estimate possible publication bias.Results8 eligible studies containing 725 I-IV LUSC patients were included. Podoplanin expression showed no significant correlations with TNM stage, vascular invasion, lymphatic invasion, lymph node metastasis, pleural metastasis of tumor and gender of patients. However, podoplanin showed significant associations with better differentiation (pooled OR = 2.64, 95% CI 1.53–4.56, P = 0.0005, fixed effect) and better overall survival (HR = 2.14, 95% CI 1.45–3.15, P = 0.0001, fixed effect) and progression-free survival (HR = 1.73, 95% CI: 1.01–2.98, P = 0.05, fixed effect) of LUSC. Funnel plots illustrated no evidence of publication bias in our results.ConclusionsPodoplanin could be a useful prognostic marker and indicates better differentiation for LUSC patients, and the value of PDPN expression as a marker for cancer stem cells in LUSC should be critically evaluated in future studies.
Highlights
The Cancer stem cells (CSCs) markers often indicate poor prognosis and more cell invasion or migration of cancer patients
Selection criteria The inclusion criteria were as follows: (I) studies had to conducted on squamous cell lung cancer patients; (II) the correlations between the expression and prognosis of PDPN has been reported; (III) PDPN expression level was measured by immunohistochemistry (IHC); (IV) the hazard ratios (HRs) and 95% confidence intervals (CIs) could be extracted directly or calculated indirectly; (V) published in English
Through full-text evaluation, 8 studies contained the data of overall survival (OS) or progression-free survival (PFS), which were suitable for this meta-analysis (Fig. 1)
Summary
The CSC (cancer stem cell) markers often indicate poor prognosis and more cell invasion or migration of cancer patients. Podoplanin was assumed as a candidate CSC marker and predict poor prognosis among squamous cancers. Progress in molecular markers have been increasingly reported to predict prognosis and survival of patients with non-small cell lung cancer (NSCLC) [1]. Cancer stem cells (CSCs) are a small subpopulation of cells within tumors with capabilities of self-renewal, differentiation, and tumorigenicity, which usually associated with resistance to therapy and poor prognosis in clinical outcomes [3]. In vivo and vitro experiments among SCC, several evidences showed that PDPN-positive cells have higher colony formation and tumorigenicity, which may act as a candidate CSC marker [13, 14]
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