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Prognostic value and clinicopathological significance of proliferating cell nuclear antigen expression in gastric cancer: a systematic review and meta-analysis

Authors Yin SC, Li Z, Huang JY, Miao ZF, Zhang JY, Lu CY, Xu H, Xu HM

Received 3 November 2016

Accepted for publication 15 November 2016

Published 10 January 2017 Volume 2017:10 Pages 319—327


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Manfred Beleut

Peer reviewer comments 2

Editor who approved publication: Dr XuYu Yang

Songcheng Yin,1,* Zhan Li,2,* Jinyu Huang,1 Zhifeng Miao,1 Junyan Zhang,1 Chunyang Lu,1 Hao Xu,1 Huimian Xu1

1Department of Surgical Oncology, 2Department of Breast Surgery, First Affiliated Hospital of China Medical University, Shenyang, People’s Republic of China

*These authors contributed equally to this work

Background: The prognostic significance of proliferating cell nuclear antigen (PCNA) expression in gastric cancer has long been assessed, yet results remain controversial. Therefore, we performed a meta-analysis to assess the prognostic value and clinicopathological significance of PCNA in gastric cancer.
Methods: A systematic literature search of PubMed, EMBASE, and the Cochrane Library databases was conducted. Summary odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to investigate the correlations between PCNA expression and clinicopathological features, overall survival (OS), and disease-free survival (DFS).
Results: A total of 19 studies involving 2,852 participants were included in our analysis. The pooled HR indicated that high PCNA expression was significantly associated with poor OS (HR 1.66, 95% CI 1.32–2.08) and DFS (HR 1.81, 95% CI 1.40–2.36). Subgroup analysis revealed that the association between PCNA and OS was also significant in Asian and European patients. In addition, the pooled ORs showed that high PCNA expression was significantly associated with deeper tumor invasion (OR 2.37, 95% CI 1.71–3.27), lymph node metastasis (OR 2.49, 95% CI 1.85–3.35), and advanced stage cancer (OR 1.89, 95% CI 1.36–2.63).
Conclusion: Our meta-analysis indicates that high PCNA expression might be a prognosticator of poor survival and a promising therapeutic target for gastric cancer patients.

Keywords: proliferating cell nuclear antigen, gastric cancer, prognosis, biomarker, meta-analysis

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