Her-2eu expression in prostate adenocarcinoma: a systematic review and meta-analysis.

摘要

PURPOSE: HER-2eu has been linked to the clinical progression of hormone independent prostate cancer. We performed a meta-analysis to investigate the prognostic impact of HER-2eu over expression in patients with prostate adenocarcinoma, and its correlation with other pathological and clinical variables. MATERIALS AND METHODS: We searched the MEDLINE, Embase, CancerLit and ASCO abstract databases for published studies of HER-2eu protein expression in primary prostate cancer tissue with a median followup of greater than 2 years and data on survival in patients with and without HER-2eu over expression. We separately analyzed studies reporting HER-2eu soluble receptor levels in patients with prostate cancer. RESULTS: We included 38 articles with a total of 5,976 patients. The overall RR of death in those with HER-2eu over expression in the primary tumor was 1.63 (95% CI 1.47-1.82, p <0.0001). In the presence of over expression the recurrence RR was 1.87 (95% CI 1.59-2.21, p <0.0001). High HER-2eu extracellular domain levels also correlated with death (RR 2.01, 95% CI 1.21-3.35, p = 0.007) and recurrence (RR 1.74, 95% CI 1.41-2.15, p <0.0001). CONCLUSIONS: There is a consistent association of HER-2eu over expression and Gleason less than 7 with a higher RR of death and recurrence in patients with prostate cancer. Further clinical trials should test the hypothesis that HER-2eu is a marker of a clinically worse outcome in patients with prostate cancer and a potential target for therapy.