High Expression Of HER-2 Is A Risk Factor For Poor Prognosis Of Colorectal Cancer

Objective:The relationship between high expression of human epidermal growt h factor receptor 2(her-2)and the prognosis and clinicopathological cha racteristics of colorectal cancer(CRC)patients has been controversial in previous studies.This study systematically assessed the correlation betwee n her-2 and the clinicopathological features and prognostic significance o f colorectal cancer using meta-analysis.Methods:Pub Med,EMBASE,Web of Science and other databases were usedt o identify studies evaluating the prognostic significance and clinicopathol ogical characteristics of HER-2 expression in CRC patients,published be fore December 31,2019.The literatures were screened by reading the ti tle,abstract and full text.The newcastle-ottawa Scale(NOS)was used to evaluate the literatures that met the inclusion criteria.The correlation bet ween HER-2 expression and overall survival was assessed by hazard rat io(HR)and 95% confidence interval(CI).The correlation between H ER-2 expression and clinical pathological features(lymph node me tastasis,TNM stage,tumor location)was assessed by odds ratio(OR)and 95%CI.After extracting the relevant data,the software Stata 13.0 software was used for the combined analysis.Results:Literature screening was ultimately included in 32 studies with 10049 colorectal cancer patients.The meta-analysis results showed that th e high expression of HER-2 was negatively correlated with the overall s urvival of CRC patients(HR=1.39,95% CI,1.19-1.62,P=0.000).In th e Asian subgroup and in the population using the Hercep Test standard scoring system,HER-2 high expression was also shown to be negatively c orrelated with CRC survival(HR = 1.64,95% CI,1.32-2.04,P=0.000;HR = 1.40,95% CI: 1.11-1.75,P=0.000).Sample stratification based o n TNM staging in 12 studies showed that compared with patients with CRC ? / ?,patients with CRC ? / ? found higher expression of H ER-2(OR = 0.66,95% CI,0.48-0.91,P=0.012).However,the heteroge neity analysis found that I2 > 50%,which indicates that there is obvi ous heterogeneity between studies.Therefore,sensitivity analysis and co ntinuous sensitivity analysis were performed.As a result,the results of the meta-analysis combined effect amount were significantly changed,in dicating that High expression of HER-2 may have no correlation with TNM stage in patients with CRC.Fifteen studies showed a relatio nship between HER-2 high expression and lymph node metastasis in patients with CRC.There was no correlation between HER-2 overexpres sion and lymph node metastasis(OR=1.12,95% CI,0.89-1.40,P=0.34).Nineteen studies evaluated the relationship between HER-2 high expres sion and tumor location(colon / rectum)in patients with CRC,sugge sting that HER-2 high expression was independent of tumor location(O R=1.06,95% CI,0.95-1.18,P=0.274)Conclusions:High expression of human epidermal growth factor receptor 2(HE R-2)is associated with shortened overall survival in patients with colore ctal cancer,suggesting poor patient prognosis.