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The prognostic value and clinicopathological significance of CD44 expression in ovarian cancer: a meta-analysis

Archives of Gynecology and Obstetrics volume 294, pages 1019–1029 (2016)Cite this article

Abstract

Purpose

The prognostic value and clinicopathological significance of CD44 in ovarian cancer (OC) remain unclear. This meta-analysis, therefore, aims to evaluate the correlation between CD44 expression and OC.

Methods

Studies published until March 2016 were searched in PubMed, EMBASE, and ISI Web of Knowledge databases. The odds ratio (OR) and the hazard ratio (HR) with 95 % confidence interval (CI) were used to assess the effects.

Results

Twenty-four studies that include 2267 OC patients were identified for the final analysis. Sixteen studies investigated the expression difference of CD44 standard (CD44s) in 1848 patients. Results showed that high CD44s expression is associated with chemoresistance (OR 5.94, 95 % CI 1.91–18.47) and short disease-free survival (DFS) time (HR 2.57, 95 % CI 1.34–4.91). In addition, CD44s expression is not associated with tumor differentiation grade, residual mass, lymphoid nodal metastasis, and overall survival (OS). Ten studies investigated the expression difference of CD44v6 in 724 patients. Results showed that the CD44v6 expression is not correlated with FIGO stage, tumor differentiation grade, lymphoid nodal metastasis, and OS.

Conclusion

High CD44s expression possibly indicates poor prognosis in OC patients given that high CD44s expression initiates chemotherapy resistance, although this expression pattern is not an independent predictive factor for OS. Meanwhile, high CD44s expression may be related to poor DFS of OC, but this relationship must be further confirmed. In addition, the result in which CD44v6 is not associated with OS of OC patients should be interpreted with caution.

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Acknowledgments

This study was funded by the National Natural Science Foundation of China (Grant Number: 81571411).

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    Affiliations

    1. Department of Gynecology and Obstetrics, PLA Medical School, Chinese People’s Liberation Army General Hospital, Beijing, China

      Luyang Zhao, Chenglei Gu, Ke Huang, Zhe Zhang, Mingxia Ye, Wensheng Fan & Yuanguang Meng

    2. Department of Gynecology and Obstetrics, The 309th Hospital of Chinese People’s Liberation Army, Beijing, China

      Chenglei Gu

    3. Department of Molecular Biology, Institute of Basic Medicine, PLA Medical School, Chinese People’s Liberation Army General Hospital, Beijing, China

      Weidong Han

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    1. Luyang Zhao
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    2. Chenglei Gu
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    3. Ke Huang
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    L. Zhao and C. Gu contributed equally to this work.

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    Supplementary material 1 (DOCX 35 kb)

    404_2016_4137_MOESM2_ESM.tif

    Supplementary material 2 (TIFF 3783 kb) Supplementary Fig. 1 Forest plots showing the association between CD44s expression and clinicopathological parameters of patients with ovarian cancer. “a” represents CD44s expression and FIGO stage; “b” represents CD44s expression and tumor differentiation grade; “c” represents CD44s expression and tumor residual mass; “d” represents CD44s expression and lymphoid nodal metastasis; “e” represents CD44s expression and recurrence

    404_2016_4137_MOESM3_ESM.tif

    Supplementary material 3 (TIFF 1925 kb) Supplementary Fig. 2 Forest plots showing the association between CD44v6 expression and clinicopathological parameters of patients with ovarian cancer. “a” represents CD44v6 expression and FIGO stage; “b” represents CD44v6 expression and tumor differentiation grade; “c” represents CD44v6 expression and lymphoid nodal metastasis

    404_2016_4137_MOESM4_ESM.tif

    Supplementary material 4 (TIFF 1811 kb) Supplementary Fig. 3 Forest plots showing the association of CD44 expression and OS of patients with ovarian cancer. “a” represents CD44s expression and OS; “b” represents CD44v6 expression and OS

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    Zhao, L., Gu, C., Huang, K. et al. The prognostic value and clinicopathological significance of CD44 expression in ovarian cancer: a meta-analysis. Arch Gynecol Obstet 294, 1019–1029 (2016). https://doi.org/10.1007/s00404-016-4137-3

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    Keywords

    • Ovarian cancer
    • CD44
    • Meta-analysis
    • Prognosis