Abstract
The prognostic role of Human leukocyte antigen class I (HLA- I) in gastrointestinal cancers has been remained controversial. We performed a meta-analysis to determine the role of classical HLA-I in predicting survival of patients. In addition, the relationship between HLA- I and some clinicopathological factors was evaluated. Published studies investigated HLA-I expression effect on gastrointestinal cancers were evaluated to determine association between HLA- I and overall survival (OS) and recurrence-free survival (RFS) in patients. The used effect sizes were hazard ratio (HR) and Odds ratio (OR) with 95% confidence interval (CI). A total of ten studies included 1307 patients were analyzed. The pooled results revealed that HLA- I overexpression was positively related to OS (HR: 0.72; 95% CI: 0.53–0.96) and demonstrated little association for RFS (HR: 0.70; 95% CI: 0.46–1.08). HLA-I overexpression is negative associated with poorer differentiation of tumor (OR: 0.53; 95% CI (0.43–0.81) and also higher stages of cancer (OR: 0.29; 95% CI (0.13–0.64). HLA- I overexpression was related to a better prognosis on OS and probably had little impact on RFS.
Highlights
The prognostic role of Human leukocyte antigen class I (HLA- I) in gastrointestinal cancers has been remained controversial
In some studies loss Human leukocyte antigens class I (HLA- I) expression has been associated with good prognosis[16,17] and the others had reported opposite result and loss expression significantly was associated with worse prognosis[18]
The inclusion criteria were as follows: (1) the clinical research on classical HLA- I expression in the gastrointestinal cancers. (2) the survival analysis with overall survival (OS) and or recurrence free survival (RFS) as outcome. (3) the patients without any limitation on age or sex. (4) the studies reported hazard ratio (HR) and 95% confidence interval (CI) or those could be estimated from other information in the paper
Summary
(2) studies which had reported impact of HLA expression combined with other clinicopathological factors on survival time. Information from eligible studies were included the first author name, year of publication, country, median follow up time, patients mean age, sample size, name of cancer, treatment, tumor differentiation, stage, number of metastasis patients and result of survival analysis. Pooled HR was obtained though combining the HR and 95% CI from all eligible studies based on HR meta- analysis guideline[23]. In addition to HRs, pooled odds ratios (ORs) were obtained in order to assessing relation between HLA- I expression level and potentially important factors. An I2 > 50% with P- value < 0.05 implied that the heterogeneity existed In this condition, the random effect model was used rather than the fixed model in order to report pooled estimate. All analyses were calculated by Stata 14 software and Pvalue < 0.05 was considered as statistically significant
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