Yonsei Med J.  2015 Nov;56(6):1497-1502. 10.3349/ymj.2015.56.6.1497.

The Prognostic Impact of Heat Shock Proteins Expression in Patients with Esophageal Cancer: A Meta-Analysis

• Wang XW
• Shi XH
• Tong YS
• Cao XF

• KMID: 2345875
• DOI: http://doi.org/10.3349/ymj.2015.56.6.1497

Abstract

PURPOSE
Heat shock proteins (HSPs) are highly conserved molecular chaperones. There are various studies that assess the prognostic value of HSPs in patients with esophageal cancer, but the conclusion remains controversial. This is the first meta-analysis study aiming to summarize the evidence on the suitability of HSPs to predict patients' survival.
MATERIALS AND METHODS
Searching PubMed, Web of science and Medline until May 31, 2014, data were compared for overall survival in patients with down-regulated HSPs level with those with up-regulated level. We conducted a meta-analysis of 9 studies (801 patients) that correlated HSPs levels with overall survival. Data were synthesized with hazard ratios (HRs).
RESULTS
The estimated risk of death was 2.93-fold greater in HSP27 negative patients than HSP27 positive patients [95% confidence interval (CI), 1.12-7.62]. When limited to esophageal squamous cell carcinoma (ESCC), the risk of death in HSP27 negative patients seemed more significant (HR, 3.90; 95% CI, 2.35-6.49). Decreased expression of HSP70 was also associated with worse survival in esophageal cancer (HR, 2.83; 95% CI, 1.90-4.23) and, when limited to ESCC, HR was 3.21 (95% CI, 1.94-5.30). Data collected, however, were not sufficient to determine the prognostic value of HSP90 in patients with ESCC nor esophageal adenocarcinomas (EADC).
CONCLUSION
In this meta-analysis, reduced HSP27 and HSP70 expressions were associated with poor survival in patients with esophageal cancer, especially esophageal squamous cell carcinoma.

Keyword

HSP27; HSP70; HSP90; esophageal cancer; survival; meta-analysis

MeSH Terms

Adenocarcinoma/*diagnosis/*metabolism/mortality
Carcinoma, Squamous Cell/diagnosis/*metabolism/therapy
Esophageal Neoplasms/*diagnosis/*metabolism/mortality/therapy
Gene Expression Regulation, Neoplastic
HSP27 Heat-Shock Proteins
HSP70 Heat-Shock Proteins
HSP90 Heat-Shock Proteins
Heat-Shock Proteins/*metabolism
Humans
Male
Neoplasm Proteins
Prognosis
Survival
Treatment Outcome
HSP27 Heat-Shock Proteins
HSP70 Heat-Shock Proteins
HSP90 Heat-Shock Proteins
Heat-Shock Proteins
Neoplasm Proteins

Figure

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  Fig. 1 Search strategy flowchart.

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  Fig. 2 Meta-analysis (forest plot) of the 5 eligible studies assessing HSP27 in esophageal cancer. SE, standard error; CI, confidence interval; HSP, heat shock protein.

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  Fig. 3 Meta-analysis (forest plot) of the 6 eligible studies assessing HSP70 in esophageal cancer. SE, standard error; CI, confidence interval; HSP, heat shock protein.

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  Fig. 4 Meta-analysis (forest plot) of the 3 eligible studies assessing HSP90 in esophageal cancer. SE, standard error; CI, confidence interval; HSP, heat shock protein.

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  Fig. 5 Begg's funnel plot for publication bias. (A) Funnel plot of HSP27. (B) Funnel plot of HSP70. SE, standard error.

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