Cancer stem cell markers predict a poor prognosis in renal cell carcinoma: a meta-analysis
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Bo Cheng1,2, Guosheng Yang2,3, Rui Jiang1, Yong Cheng1, Haifan Yang1, Lijun Pei1, Xiaofu Qiu2,3
1 Department of Urology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
2 Southern Medical University, Guangzhou 510280, China
3 Department of Urology, Guangdong No.2 Provincial People’s Hospital, Guangzhou 510317, China
Guosheng Yang, email: firstname.lastname@example.org
Rui Jiang, email: email@example.com
Keywords: renal cancer, prognosis, cancer stem cells, biomarker, meta-analysis
Received: March 31, 2016 Accepted: August 10, 2016 Published: August 29, 2016
Background: Relevant markers of CSCs may serve as prognostic biomarkers of RCC. However, their actual prognostic significance remains inconclusive. Thus, a meta-analysis was performed to reevaluate the association of CSCs-relevant markers (CXCR4, CD133, CD44, CD105) expression with RCC prognosis more precisely.
Methods: PubMed and Embase were searched to look for eligible studies. The pooled hazard ratios (HR) with 95% confidence intervals (95% CI) were used to reassess the association of CSCs markers expression and RCC prognosis of overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and progression-free survival (PFS).
Results: There were 25 relevant articles, encompassing 2673 RCC patients, eligible for meta-analysis. Overall pooled analysis suggested that high CSCs markers expression predicted poor OS (HR, 2.10, 95% CI: 1.73–2.55) and DFS (HR, 3.77, 95% CI: 2.30–6.19). High CXCR4 expression predicted worse OS (HR, 2.57, 95% CI: 1.95–3.40), CSS (HR,1.97, 95% CI: 1.50–2.59), and DFS (HR, 5.82, 95% CI: 3.01–11.25). CD44 over-expression correlated with a poor OS(HR,1.58, 95% CI: 1.14–2.18), CSS (HR, 2.58, 95% CI: 1.27–5.23), and DFS (HR, 4.49, 95% CI: 2.12–9.53) in RCC patients. CD133 was an independent favorable prognostic factor for CSS (HR, 0.4, 95% CI: 0.29–0.54).
Conclusions: The presence of CSCs markers correlates with poor RCC outcome. CSCs may be potentially utilized as prognostic markers to stratify RCC patients, probably representing also a novel potential therapeutic target.
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