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Meta-Analysis
. 2014 Apr 11;9(4):e94508.
doi: 10.1371/journal.pone.0094508. eCollection 2014.

Prognostic significance of cyclin D1 expression in colorectal cancer: a meta-analysis of observational studies

Yang Li  1 , Jun Wei  1 , Chuanhui Xu  2 , Zhongxin Zhao  1 , Tiangeng You  1
Affiliations
Meta-Analysis

Prognostic significance of cyclin D1 expression in colorectal cancer: a meta-analysis of observational studies

Yang Li et al. PLoS One. .

Abstract

Objective: Cyclin D1 plays a vital role in cancer cell cycle progression and is overexpressed in many human cancers, including colorectal cancer (CRC). However, the prognostic value of cyclin D1 overexpression in colorectal cancer is conflicting and heterogeneous. We conducted a meta-analysis to more precisely evaluate its prognostic significance.

Methods: A comprehensive literature search for relevant studies published up to January 2014 was performed using PubMed, EMBASE, and ISI Web of Science. The pooled hazard ratio (HR) with 95% confidence intervals (CI) was used to estimate the effects.

Results: 22 studies with 4150 CRC patients were selected to evaluate the association between cyclin D1 and overall survival (OS), disease-free survival (DFS) and clinicopathological parameters. In a random-effects model, the results showed that cyclin D1 overexpression in CRC was significantly associated with both poor OS (HR = 0.73, 95% CI: 0.63-0.85, P<0.001) and DFS (HR = 0.60, 95% CI: 0.44-0.82, P = 0.001). Additionally, cyclin D1 overexpression was significantly associated with more relative older patients (≥ 60 years) (OR 0.62, 95% CI 0.44-0.89, P = 0.009), T3,4 tumor invasion (OR 0.70, 95% CI 0.57-0.85, P<0.001), N positive (OR 0.75, 95% CI 0.60-0.95, P = 0.016) and distant metastasis (OR 0.60, 95% CI 0.36-0.99, P = 0.047) of CRC.

Conclusion: The meta-analysis results indicated that cyclin D1 is an unfavorable prognostic factor for CRC. Cyclin D1 overexpression might be associated with poor clinical outcome and some clinicopathological factors such as age, T category, N category and distant metastasis in CRC patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram of screened, excluded, and analyzed publications.
Figure 2
Figure 2. Forest plot of the hazard ratio (HR) for the association of cyclin D1 expression with overall survival (OS).
Horizontal lines represent 95% CI. Each box represents the HR point estimate, and its area is proportional to the weight of the study. The diamond (and broken line) represents the overall summary estimate, with CI represented by its width. The unbroken vertical line indicates the null value (HR = 1).
Figure 3
Figure 3. Forest plot of the hazard ratio (HR) for the association of cyclin D1 expression with disease-free survival (DFS).
Figure 4
Figure 4. Sensitivity analysis based on stepwise omitting one study at a time for overall survival (OS).
Figure 5
Figure 5. Sensitivity analysis based on stepwise omitting one study at a time for disease-free survival (DFS).
Figure 6
Figure 6. Begg's funnel plot for the evaluation of potential publication bias on overall estimate of overall survival (OS).
Figure 7
Figure 7. Begg's funnel plot for the evaluation of potential publication bias on overall estimate of disease-free survival (DFS).
See this image and copyright information in PMC

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