大林慈濟醫院 泌尿科1；國立成功大學醫學院暨附設醫院 泌尿部2
Significance of HER2 expression in Upper Tract Urothelial Carcinoma: a meta-analysis
Chia-Horng Chen1, Yuh-Shyan Tsai2, Tzong-Shin Tzai2
1Department of Urology1, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-yi County, Taiwan.
2Department of Urology, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
Introduction: Several studies explored the prognostic values of HER2 expression in upper tract urothelial carcinoma (UTUC), but the results remain not consistent.
Materials and Methods: Using published evidence, we performed a meta-analysis to examine its clinical values in patients with UTUC. Thirty-five articles from 679 references related to EGFR family expression assessment in UTUC were reviewed and there were 7 papers fit for analyses. The estimates included the odds ratio (OR), distribution related to stage and grade, hazard ratios (HR), and 95% confidence intervals (CI) from survival analyses of intravesical recurrence, progression and overall survival.
Results: The pooled results showed that HER2 expression is significantly associated with higher stage, but not with tumor grade in patients with UTUC (OR, 2.05; 95% CI, 1.15-3.68; p =0.016 and OR, 4.73; 95% CI, 0.80-27.8; p =0.086, respectively). Also, the pooled survival analyses demonstrated that HER2 expression yielded a worse recurrence-free survival in UTUC patients (HR, 4.32; 95% CI, 2.17-8.60; p < 0.0001). However, there is lack of statistical significance in term of progression-free survival an overall survival (HR, 2.08; 95%CI, 0.46-9.32; p = 0.339 and HR, 1.06; 95% CI, 0.48-2.37; p = 0.879, respectively).
Conclusion: The relevant studies existed heterogeneous and were limited. Our analysis suggests that HER2 expression plays an important role in subsequent recurrence in the urinary bladder after primary treatment for UTUC.