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Prognostic significance of cytokeratin 19 expression in pancreatic neuroendocrine tumor: A meta-analysis.

ABSTRACT: Pancreatic neuroendocrine tumor (PNET) comprises 1-2% of all pancreatic tumors, but its incidence is increasing. Although many studies have investigated the correlation between cytokeratin 19 (CK-19) and PNET, the prognostic significance of CK-19 expression in PNET is inconclusive.Eligible studies were retrieved from Pubmed, Elsevier, Embase, Cochrane Library and Web of Science databases. All relevant data were extracted to analyze the relationship between CK-19 and PNET. We utilized a fixed or random effects model to calculate the pooled odds ratio (OR) with 95% confidence intervals (CI).Pooled data indicated CK-19 expression was significantly associated with poor 3- and 5-year overall survival (OS) for PNET, but not for 1-year overall survival. Additionally, positive CK-19 expression was correlated with large tumor size, advanced differentiation grade in World Health Organization-2010 (WHO-2010) and WHO-2004, vascular invasion, lymph node metastasis and liver metastasis.Positive CK-19 expression can be used as a predictor of poor prognosis of PNET.

SUBMITTER: Cen D

PROVIDER: S-EPMC5685577 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Prognostic significance of cytokeratin 19 expression in pancreatic neuroendocrine tumor: A meta-analysis.

Cen Dong D Chen Jiang J Li Zheyong Z Zhao Jie J Cai Xiujun X

PloS one 20171114 11

<h4>Background</h4>Pancreatic neuroendocrine tumor (PNET) comprises 1-2% of all pancreatic tumors, but its incidence is increasing. Although many studies have investigated the correlation between cytokeratin 19 (CK-19) and PNET, the prognostic significance of CK-19 expression in PNET is inconclusive.<h4>Methods</h4>Eligible studies were retrieved from Pubmed, Elsevier, Embase, Cochrane Library and Web of Science databases. All relevant data were extracted to analyze the relationship between CK-1 ...[more]

PMID: 29136022

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Project description:BackgroundPancreatic neuroendocrine tumors (PanNETs) are a heterogeneous group of neoplasms with increasing incidence and unpredictable behavior. Whole-exome sequencing recently has shown very frequent somatic mutations in the alpha-thalassemia/mental retardation X-linked (ATRX) and death domain-associated protein (DAXX) genes in PanNETs. And the prognostic significance of altered ATRX/DAXX genes in PanNETs patients have been revealed in several reports. However, many of these include small sample size and hold controversial opinions. To increase statistical power, we performed a systematic review and meta-analysis to determine a pooled conclusion. We examined the impact of altered ATRX/DAXX genes mainly on overall survival (OS), disease-free survival (DFS) and relapse-free survival (RFS) in PanNETs.MethodsEligible studies were identified and quality was assessed using multiple search strategies (last search May 2021). Data were collected from studies about prognostic significance of altered ATRX/DAXX in PanNETs. Studies were pooled, and combined hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate strength of the associations.ResultsFourteen studies involving 2313 patients treated for PanNETs were included. After evaluating for publication bias, disease-free survival and relapse-free survival was significantly shortened in patients with altered ATRX/DAXX gene, with combined HR 5.05 (95% confidence interval (CI): 1.58-16.20, P = 0.01) and 3.21 (95% confidence interval (CI): 1.44-7.16, P < 0.01) respectively. However, the combined data showed there were no difference between patients with altered ATRX/DAXX gene or not in overall survival, with a combined HR 0.71 (95% confidence interval (CI): 0.44-1.15, P = 0.23). We also performed a subgroup analysis with metastatic patients in overall survival, showing a combined HR 0.22 (95% confidence interval (CI): 0.11-0.48, P = 0.96). The small number of studies and paucity of multivariate analyses are the limitations of our study.ConclusionsThis is the first rigorous pooled analysis assessing ATRX/DAXX mutation as prognostic biomarkers in PanNETs. Patients with altered ATRX/DAXX gene would have poor DFS according to the combined data. And altered ATRX/DAXX genes in metastatic patients showed a trend towards improved overall survival, although the difference did not reach statistical significance.

Project description:BackgroundAn increasing number of studies have examined the ability of programmed death-ligand 1 (PD-L1) to function as a marker for tumor prognosis. However, whether PD-L1 expression is a prognostic factor for the poor outcomes in many human cancers remains controversial. This study aims to investigate the prognostic role of PD-L1 expression through a meta-analysis update of 60 studies.MethodsThe studies were identified by searching PubMed, Embase, Google Scholar, and Cochrane Library, and were assessed by further quality evaluation. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for total and stratified analyses were calculated to investigate the association between the PD-L1 expression and the overall (OS) and disease-free (DFS) or progression-free survivals (PFS) of cancer patients. Heterogeneity and publication bias were also investigated.ResultsThe results indicated that PD-L1 overexpression can predict a poor OS (HR = 1.58, 95% CI = 1.38-1.81, P <.000) and DFS/PFS (HR = 1.72, 95% CI = 1.26-2.33, P = .001). Subgroup analyses showed that PD-L1 overexpression was significantly related to the poor OS in patients with breast (HR = 1.98, 95% CI = 1.15-3.41, P = .014), urothelial (HR = 2.24, 95% CI = 1.61-3.12, P <.000), renal (HR = 3.30, 95% CI = 2.23-4.86, P <.000), and gastric cancers (HR = 1.56, 95% CI = 1.02-2.37, P = .040). Furthermore, PD-L1 overexpresion was significantly associated with poor DFS/PFS in patients with hepatocellular carcinoma (HCC) (HR = 1.72, 95% CI = 1.21-2.46, P = .003), melanoma (HR = 3.39, 95% CI = 2.02-5.69, P <.000), and renal carcinoma, (HR = 5.04, 95% CI = 2.87-8.86, P <.000). The adverse prognostic impact of PD-L1 was observed in patients of different ethnicities.ConclusionsThe findings of this meta-analysis suggest the correlation of PD-L1 overexpression with worse OS in patients with solid tumors. However, the correlations differed according to tumor types.

Dataset Information

Prognostic significance of cytokeratin 19 expression in pancreatic neuroendocrine tumor: A meta-analysis.

Publications

Prognostic significance of cytokeratin 19 expression in pancreatic neuroendocrine tumor: A meta-analysis.

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