Background: Heparanase is believed to be involved in gastric carcinogenesis. However, the clinicopathologic features of gastric cancer with high heparanase expression remain unclear. Aim : The purpose of this study was to comprehensively and quantitatively summarize available evidence for the use of heparanase mRNA and protein expression to evaluate the clinicopathological associations in gastric cancer in Asian patients by meta-analysis. Materials and Methods: Relevant articles listed in MEDLINE, CNKI and the Cochrane Library databases up to MARCH 2015 were searched by use of several keywords in electronic databases. A meta-analysis was performed to clarify the impact of heparanase mRNA and protein on clinicopathological parameters in gastric cancer. Combined ORs with 95%CIs were calculated by Revman 5.0, and publication bias testing was performed by stata12.0. Results: A total of 27 studies which included 3,891 gastric cancer patients were combined in the final analysis. When stratifying the studies by the pathological variables of heparanase mRNA expression, the depth of invasion (633 patients) (OR=4.96; 95% CI=2.38-1.37; P0.0001), lymph node metastasis (639 patients) (OR=6.22; 95%CI=2.70-14.34, P0.0001), and lymph node metastasis (383 patients) (OR=6.85; 95% CI=2.04-23.04; P=0.002) were all significant. When stratifying the studies by the pathological variables of heparanase protein expression, this was the case for depth of invasion (1250 patients) (OR=2.76; 95% CI=1.52-5.03; P=0.0009), lymph node metastasis (1178 patients) (OR=4.79 ; 95% CI=3.37-6.80, P0.00001), tumor size (727 patients) (OR=2.06 ; 95% CI=1.31-3.23; P=0.002) (OR=2.61; 95% CI=2.09-3.27; P=0.000), and TNM stage (1233 patients) (OR=6.85; 95% CI=2.04-23.04; P=0.002). Egger's tests suggested publication bias for depth of invasion, lymph node metastasis, lymph node metastasis and tumor size of heparanase mRNA and protein expression. Conclusions: This meta-analysis suggests that higher heparanase expression in gastric cancer is associated with clinicopathologic features of depth of invasion, lymph node metastasis and TNM stage at mRNA and protein levels, and of tumor size only at the protein level. Egger's tests suggested publication bias for these clinicopathologic features of heparanase mRNA and protein expression, and which may be caused by shortage of relevant studies. As a result, although abundant reports showed heparanase may be associated with clinicopathologic features in gastric cancer, this meta-analysis indicates that more strict studies were needed to evaluate its clinicopathologic significance.
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机译：背景：据信乙酰肝素酶参与胃癌发生。然而，具有高乙肝素酶表达的胃癌的临床病理特征仍然尚不清楚。目的：本研究的目的是全面和定量地总结使用肝胰酶mRNA和蛋白表达的可用证据，以评估亚洲患者胃癌的临床病理学关联通过META分析。材料和方法：通过在电子数据库中使用多个关键字，搜索在2015年3月的Medline，CNKI和Cochrane库数据库中列出的相关文章。进行了META分析以阐明肝素酶mRNA和蛋白对胃癌临床病理参数的影响。通过Revman 5.0计算具有95％CIS的组合或具有95％CI，并且通过Stata12.0执行出版物偏置测试。结果：共有27项研究，其中包括3,891名胃癌患者在最终分析中合并。当通过乙酰肝素酶mRNA表达的病理变量进行分层，侵袭症（633名患者）（或= 4.96; 95％CI = 2.38-1.37; P <0.0001），淋巴结转移（639名患者）（或= 6.22 ; 95％CI = 2.70-14.34，P <0.0001）和淋巴结转移（383名患者）（或= 6.85; 95％CI = 2.04-23.04; p = 0.002）都是显着的。当通过乙酰肝素酶蛋白表达的病理变量进行分层时，这是侵袭浸润（1250名患者）的情况（或= 2.76; 95％CI = 1.52-5.03; P = 0.0009），淋巴结转移（1178名患者） （或= 4.79; 95％CI = 3.37-6.80，P <0.00001），肿瘤大小（727名患者）（或= 2.06; 95％CI = 1.31- 3.23; P = 0.002）（或= 2.61; 95％CI = 2.09-3.27; p = 0.000），TNM阶段（1233名患者）（或= 6.85; 95％CI = 2.04-23.04; p = 0.002）。 Egger的测试表明出版出版物偏见，浸润偏见，淋巴结转移，肝脏酶mRNA和蛋白表达的淋巴结转移和肿瘤大小。结论：该荟萃分析表明，胃癌中肝脏酶表达较高与mRNA和蛋白水平的侵袭，淋巴结转移和TNM阶段的临床病理特征有关，并且仅在蛋白质水平处的肿瘤大小。 Egger的测试表明肝胰酶mRNA和蛋白表达的这些临床病理特征的出版物偏见，并且可能是由于相关研究的短缺引起的。结果，虽然富裕的报告显示乙酰肝素酶可能与胃癌中的临床病理特征有关，但这种荟萃分析表明，需要更严格的研究来评估其临床病理学意义。
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