Prognosis And Clinicopathological Parameters Of Human Epidermal Growth Factor Receptor 2 In Relation To Patients With Gastric Or Gastroesophageal Junction Cancer:a Meta-analysis

OBJECTIVE:Human epidermal growth factor receptor 2(HER-2)is a member of the epidermal growth factor receptor(EGFR)family,which regulates various biological processes including cell proliferation,invasion and migration,differentiation,and autophagy.HER-2 is expressed in a variety of cancers,but its significance in gastric cancer is controversial.In this study,we used a meta-analysis to systematically assess the correlation between HER-2 expression and the prognosis and clinicopathological characteristics of gastric cancer patients.METHODS:We searched Web Of Science,Embase,Pub Med,Cochran and other databases for studies on the correlation between HER-2 expression and prognosis and clinical case characteristics of gastric cancer patients.The search period was from 2012 to2022.Literature screening was performed by reading article titles,abstracts,and full text.The Newcastle-Ottawa Scale(NOS)was used to evaluate the quality of the literature.Survival data and clinicopathological parameters were extracted from the literature,and the combined effect size was calculated by applying the risk ratio(HR,hazard ratio)and 95% confidence interval(95% CI)for survival data,and the OR(odds ratio)and 95% confidence interval(95% CI)for clinicopathological parameters.Data analysis was performed by Review Manager 5.4.1 software.RESULTS:Based on the inclusion and exclusion criteria,23 papers with a total of 8906 patients were finally included in the literature.The meta-analysis of the included literature showed that 19 papers with univariate analysis of HER-2 expression correlated with overall survival in patients with gastric or GEJ adenocarcinoma(HR=1.62,95% CI 1.19-2.22,P=0.002).The meta results of multifactorial overall survival analysis similarly showed that high HER-2 expression was significantly associated with shorter overall survival in patients(HR=1.62,95% CI 1.43-1.85,P<0.00001).With regard to clinicopathological parameters,gender,age,tumor location,Lauren’s staging and degree of tumor differentiation were significantly correlated with HER-2 expression status,with statistically significant differences.In contrast,the depth of tumor infiltration,clinical stage,lymph node metastasis,vascular infiltration,neural invasion and distant metastasis were not significantly correlated with the expression of HER-2.CONCLUSION:Human epidermal growth factor receptor 2(HER-2)expression correlated with overall survival of patients with gastric or GEJ cancer,and HER-2 positivity was a risk factor for patients with gastric or GEJ adenocarcinoma.