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. 2016 Jun 17:16:47.
doi: 10.1186/s12935-016-0325-2. eCollection 2016.

Prognostic value of CD44 expression in patients with hepatocellular carcinoma: meta-analysis

Yangkun Luo  1 , Yan Tan  1
Affiliations

Prognostic value of CD44 expression in patients with hepatocellular carcinoma: meta-analysis

Yangkun Luo et al. Cancer Cell Int. .

Abstract

Background: CD44 has been reported to be involved with tumor growth and metastasis and has also been implicated as a CSC marker in hepatocellular carcinoma (HCC). However, the prognostic value of CD44 still remains controversial; hence, we investigated the correlation between CD44 and the clinicopathological features of HCC by meta-analysis.

Methods: Identification and review of publications assessing clinical or prognostic significance of CD44 expression in HCC until November 1, 2015. A meta-analysis was performed to clarify the association between CD44 expression and clinical outcomes.

Results: A total of 14 publications met the criteria and comprised 2235 cases. Analysis of these data showed that CD44 expression was not significantly associated with the tumor differentiation (OR 1.48, 95 % confidence interval [CI] 0.85-2.60, P = 0.17), AFP level of HCC patients (OR 0.83, 95 % CI 0.52-1.33, P = 0.45), or disease-free survival (relative risk [RR] 1.15, 95 % CI, 0.85-1.54; P = 0.36). However, in the identified studies, CD44 expression was highly correlated with tumor TNM classification (OR 2.38, 95 % CI 1.23-4.60; P = 0.01) and decreased overall survival (RR 1.49, 95 % CI, 1.26-1.76; P < 0.00001).

Conclusions: This meta-analysis shows CD44 expression in HCC is connected with decreased overall and thus marks a worse prognosis.

Keywords: CD44; Disease-free survival; Meta-analysis; Overall survival; Prognosis.

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Figures

Fig. 1
Fig. 1
Literature search strategy and selection of articles
Fig. 2
Fig. 2
Forest plot depiction of CD44 expression and OR for clinical pathologic features. Clinicopathological parameters investigated are (a) TMN classification, (b) tumor grade (c)AFP level
Fig. 3
Fig. 3
Forest plot illustrates the association between CD44 expression and OS of HCC
Fig. 4
Fig. 4
Analysis of CD44 expression and DFS among included studies
Fig. 5
Fig. 5
Begg’s funnel plot estimated the publication bias of the included literature for OS (a) and DFS (b)
Fig. 6
Fig. 6
Sensitivity analysis of all the studies assessing OS (a) and DFS (b)
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