Abstract
BackgroundCurrent researches have revealed that delta-like protein 3 (DLL3) may be related with prognosis in patients with small cell lung cancer (SCLC). However, this finding remains controversial in small cell lung cancer. This meta-analysis was systematically performed to evaluate the prognostic value of DLL3 in SCLC.MethodsThe PubMed, EMBASE and Web of Science databases were retrieved to collect the eligible references. Through Stata 15.0 software, we pooled hazard ratios (HR) with 95% confidence intervals (CI) by using random or fixed-effects models to evaluate the association between DLL3 and SCLC survival results.ResultsA total of 6 inter-related studies including 645 patients were qualified. After we removed 1 study, the remaining 5 studies including 601 patients were pooled to testify that high expression of DLL3 was an inferior prognostic for patients with SCLC in Asian populations (HR = 1.37, 95% CI = 1.05, 1.69; I2 = 0.0%, p = 0.000). The pooled results showed that DLL3 might be higher expression in advanced metastasis SCLC in Asian populations (RR = 0.84, 95% CI = 0.71, 0.99; I2 = 44.7%, p = 0.039). But the expression of DLL3 was not correlated with sex (RR = 1.33, 95% CI = 0.98, 1.80; I2 = 0.0%, p = 0.064), smoking history (RR = 1.01, 95% CI = 0.58, 1.75; I2 = 72.1%, p = 0.967) and tumour stage (RR = 0.68, 95% CI = 0.44, 1.05; I2 = 66.6%, p = 0.081).ConclusionsOur meta-analysis confirms that in Asian populations, high expression of DLL3 was a potential poor prognostic biomarker for SCLC and DLL3 highly expressed in advanced stage SCLC in Asian populations.
Highlights
Lung cancer has the highest morbidity and mortality of all malignant tumours, which is one of the most common cancers worldwide [1]
Some of the researchers demonstrated that delta-like protein 3 (DLL3) had no correlation with prognosis in small cell lung cancer (SCLC) patients [10, 11], but other investigators showed that DLL3 was associated with the survival of patients with SCLC [12]
After screening the titles and abstracts of the 74 publications, 58 publications were not related to evaluating the prognosis role of DLL3 in SCLC
Summary
Lung cancer has the highest morbidity and mortality of all malignant tumours, which is one of the most common cancers worldwide [1]. Delta-like protein 3 (DLL3) is a transmembrane protein that promotes the development of neuroendocrine tumours through its reciprocity with the Notch pathway [5] It is expressed in cancer tissues in approximately 85% of patients with SCLC and other neuroendocrine cancer but is not expressed in non-neuroendocrine. Current researches have revealed that delta-like protein 3 (DLL3) may be related with prognosis in patients with small cell lung cancer (SCLC). This finding remains controversial in small cell lung cancer. This meta-analysis was systematically performed to evaluate the prognostic value of DLL3 in SCLC
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