Image_4_The Prognostic and Clinical Value of CD44 in Colorectal Cancer: A Meta-Analysis.TIF
Background: CD44 is widely used as a putative cancer stem cells (CSCs) marker for colorectal cancer (CRC). However, the prognostic role of CD44 in CRC remains controversial.
Methods: We performed a systematic review and meta-analysis to evaluate the association of various CD44 isoforms and overall survival (OS) and clinicopathological features of CRC patients.
Results: A total of 48 studies were included in the meta-analysis. Total CD44 isoforms overexpression was significantly correlated with worse OS of patients with CRC (HR = 1.32, 95% CI = 1.08–1.61, P = 0.007). In a stratified analysis, a higher level of either CD44v6 or CD44v2 had an unfavorable impact on OS (HRCD44v6 = 1.50, 95% CI = 1.10–2.14, P = 0.010; HRCD44v2 = 2.93, 95% CI = 1.49–5.77, P = 0.002). Additionally, CD44 was shown to be associated with some clinicopathological features, such as lymph node metastasis (ORCD44 = 1.56, 95% CI = 1.01–2.41, P = 0.044; ORCD44v6 = 1.97, 95% CI = 1.19–3.26, P = 0.008; ORTotal CD44 isoforms = 1.57, 95% CI = 1.15–2.14, P = 0.004), distant metastasis (ORCD44 = 2.90, 95% CI = 1.08–7.83, P = 0.035; ORTotal CD44 isoforms = 1.89, 95% CI = 1.02–3.53, P = 0.044). Moreover, a high level of CD44 showed a possible correlation with poor differentiation (ORTotal CD44 isoforms = 1.44, 95% CI = 1.00–2.08, P = 0.051), elevated level of CD44v6 tend to be correlated with tumor size (OR = 1.71, 95% CI = 0.99–2.96, P = 0.056).
Conclusions: This meta-analysis demonstrated that CD44 overexpression might be an unfavorable prognostic factor for CRC patients and could be used to predict poor differentiation, lymph node metastasis and distant metastasis.
History
References
- https://doi.org//10.3322/caac.21492
- https://doi.org//10.1093/annonc/mdu260
- https://doi.org//10.1245/s10434-018-6462-1
- https://doi.org//10.1038/nrc1232
- https://doi.org//10.1158/1078-0432.ccr-15-1348
- https://doi.org//10.1038/nature03128
- https://doi.org//10.1038/nature05372
- https://doi.org//10.1073/pnas.0703478104
- https://doi.org//10.1158/1078-0432.ccr-08-1034
- https://doi.org//10.1111/j.1349-7006.2004.tb03179.x
- https://doi.org//10.1128/mcb.26.1.362-370.2006
- https://doi.org//10.1074/jbc.M709051200
- https://doi.org//10.1038/nrm1004
- https://doi.org//10.3109/1061186x.2012.702767
- https://doi.org//10.1038/nrc3023
- https://doi.org//10.1016/s0014-5793(02)03262-3
- https://doi.org//10.1001/archotol.132.7.771
- https://doi.org//10.1158/0008-5472.can-04-3478
- https://doi.org//10.1186/1471-2407-14-15
- https://doi.org//10.1700/1248.13794
- https://doi.org//10.1186/s13000-015-0411-0
- https://doi.org//10.3393/ac.2015.31.3.84
- https://doi.org//10.1038/sj.bjc.6605762
- https://doi.org//10.1055/s-2002-25152
- https://doi.org//10.1016/j.biopha.2014.08.001
- https://doi.org//10.1186/s12935-016-0325-2
- https://doi.org//10.1038/srep13157
- https://doi.org//10.1186/s12935-016-0376-4
- https://doi.org//10.1136/bmj.b2535
- https://doi.org//10.1002/jso.20638
- https://doi.org//10.1080/07357900902744502
- https://doi.org//10.1007/s12029-018-0156-6
- https://doi.org//10.1016/j.tranon.2016.12.005
- https://doi.org//10.3892/ol.2017.6269
- https://doi.org//10.3233/cbm-160592
- https://doi.org//10.1111/j.1440-1827.2009.02357.x
- https://doi.org//10.3748/wjg.15.2258
- https://doi.org//10.3892/ijo.2012.1598
- https://doi.org//10.1081/cnv-200039658
- https://doi.org//10.1007/s00432-004-0596-1
- https://doi.org//10.3892/or.2013.2273
- https://doi.org//10.1038/bjc.2014.253
- https://doi.org//10.1007/s00428-004-1095-0
- https://doi.org//10.1111/j.1365-2559.2009.03421.x
- https://doi.org//10.1136/bmj.d2090
- https://doi.org//10.1093/jnci/djy088
- https://doi.org//10.1002/sim.1186
- https://doi.org//10.1159/000163907
- https://doi.org//10.1007/s12029-009-9100-0
- https://doi.org//10.3760/cma.j.issn.0376-2491.2018.36.005
- https://doi.org//10.1006/jsre.2001.6312
- https://doi.org//10.3748/wjg.v18.i33.4549
- https://doi.org//10.3889/oamjms.2016.126
- https://doi.org//10.1007/s12029-009-9062-2
- https://doi.org//10.1007/pl00010042
- https://doi.org//10.1159/000011970
- https://doi.org//10.1016/j.prp.2015.05.006
- https://doi.org//10.3892/or.2017.5790
- https://doi.org//10.3109/07357907.2015.1047507
- https://doi.org//10.1097/SLA.0b013e31829b3916
- https://doi.org//10.3892/ijo.2015.2844
- https://doi.org//10.5812/ijcm.9166
- https://doi.org//10.1073/pnas.0610117104
- https://doi.org//10.1038/sj.bjc.6604242
- https://doi.org//10.1073/pnas.0530291100
- https://doi.org//10.1158/0008-5472.can-08-0364
- https://doi.org//10.4137/geg.s35500
- https://doi.org//10.1186/s12957-015-0746-8
- https://doi.org//10.1371/journal.pone.0057314
- https://doi.org//10.1172/jci44540
- https://doi.org//10.1002/jso.23705
- https://doi.org//10.1371/journal.pone.0044078
- https://doi.org//10.1016/j.ccr.2011.01.038