Effect of HER-2/neu Over-expression on Prognosis in Gastric Cancer: a Meta-analysis

Background: Her-2/neu is the most frequently studied molecular target in gastric cancer but its prognostic impact is still equivocal. We therefore conducted a meta-analysis to more precisely estimate its prognostic significance.

Methods: Published studies that investigated between Her-2/neu status and survival were identified. Meta-analysis was performed by Dersimonian-Laird model. Pooled hazard ratio (HR) and its 95% confidence interval (95%CI) were calculated to evaluate the risk of disease.

Results: A total of 19 studies were analyzed by meta-analysis method, cumulative 4342 cases were included. Pooled data of 15 studies using univariate analysis showed worse survival of patient with her-2/neu (+) (pooled HR=1.59, 95%CI: 1.20-2.12), which maintained in 7 studies of multivariate analysis (pooled HR=1.58, 95%CI: 1.18-2.12). The Q statistic test for 15 studies of univariate analysis and for 7 studies of multivariate analysis showed they had heterogeneity (Q=26.98, p=0.019, Q=17.76, p=0.007, respectively).

Conclusion: HER-2/neu over-expression is related to poor prognosis of gastric cancer but has a modest effect on survival in gastric cancer as an independent prognosis factor.