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Prognostic values of HE4 expression in patients with cancer: a meta-analysis

Authors Dai C, Zheng Y, Li Y, Tian T, Wang M, Xu P, Deng Y, Hao Q, Wu Y, Zhai Z, Dai Z, Lyu J

Received 26 June 2018

Accepted for publication 10 August 2018

Published 10 October 2018 Volume 2018:10 Pages 4491—4500

DOI https://doi.org/10.2147/CMAR.S178345

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Giandomenico Roviello

Peer reviewer comments 3

Editor who approved publication: Dr Antonella D'Anneo


Cong Dai,1,2,* Yi Zheng,2,* Yuanjie Li,3 Tian Tian,2 Meng Wang,2 Peng Xu,2 Yujiao Deng,2 Qian Hao,2 Ying Wu,2 Zhen Zhai,2 Zhijun Dai,2 Jun Lyu1

1Clinical Research Center, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China; 2Department of Oncology, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, 710004, People’s Republic of China; 3Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of China

*These authors contributed equally to this work

Background: To evaluate the prognostic impact of HE4 expression in patients with cancer.
Materials and methods: We searched the PubMed, Web of Science, Chinese National Knowledge Infrastructure and WangFang databases for publications concerning HE4 expression in patients with cancer. The correlation of HE4 expression level with overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) was analyzed.
Results: In this meta-analysis, 29 studies, with a total of 4,235 patients, were included. Our results showed that HE4 expression was significantly associated with poorer OS (hazard ratio [HR] =2.15, 95% confidence interval [CI] =1.77–2.62, P<0.001). Further subgroup analysis found that this correlation was not affected by race (White: HR =1.92, 95% CI =1.53–2.39, P<0.001; Asian: HR =2.62, 95% CI =2.06–3.35, P<0.001) or tumor types (endometrial cancer: HR =2.91, 95% CI =1.86–4.53, P<0.001; ovarian cancer: HR =1.82, 95% CI =1.50–2.22, P<0.001; lung cancer: HR =2.31, 95% CI =1.54–3.47, P<0.001). Our meta-analysis showed that HE4 overexpression was significantly associated with DFS (HR =2.50, 95% CI =1.86–3.37, P<0.001) and PFS (HR =1.27, 95% CI =1.11–1.45, P=0.001).
Conclusion: These results suggest that expression of HE4 was associated with a worse prognosis in patients with cancer. HE4 is a potential novel prognostic factor in patients with cancer.

Keywords: HE4, cancer, prognosis, meta-analysis

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