Meta-Analysis
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World J Gastroenterol. Jul 21, 2014; 20(27): 9191-9199
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9191
Role of Notch signaling pathway in gastric cancer: A meta-analysis of the literature
Xiao Du, Zhong Cheng, Yi-Han Wang, Zi-Heng Guo, Si-Qin Zhang, Jian-Kun Hu, Zong-Guang Zhou
Xiao Du, Zhong Cheng, Yi-Han Wang, Zi-Heng Guo, Si-Qin Zhang, Jian-Kun Hu, Zong-Guang Zhou, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Du X and Wang YH performed the majority of this work; Cheng Z performed the research; Guo ZH and Zhang SQ were involved in editing the manuscript; Hu JK and Zhou ZG designed the study and revised the manuscript.
Supported by National Natural Science Foundation of China, No. 81071777; and Sichuan Province Science and Technology Support Program, No. 2011SZ0293 and No. 2011SZ0087
Correspondence to: Jian-Kun Hu, Professor, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. hujkwch@126.com
Telephone: +86-28-85422872 Fax: +86-28-85422484
Received: January 17, 2014
Revised: February 27, 2014
Accepted: April 30, 2014
Published online: July 21, 2014
Abstract

AIM: To perform a meta-analysis to quantitatively summarize the evidence for the association between the Notch signaling pathway and gastric cancer (GC).

METHODS: An electronic search of the MEDLINE, EMBASE and Chinese National Knowledge Infrastructure, which contain articles published from 1966 onwards, was conducted to select studies for this meta-analysis.

RESULTS: Fifteen studies with a total of 1547 gastric cancer cases and 450 controls were included in this meta-analysis. Overall, the expression of Notch1, Notch2, Delta-like 4 and Hes1 was significantly higher in tumor tissues of GC compared to normal tissues. Specifically, stratified analyses showed that significantly increased expression of Notch1 was associated with non-cardia location, > 5 cm size, diffuse type, positive lymphovascular invasion and distal metastasis. Statistically significant higher expression of Notch3 was found in diffuse type GC. Jagged1 was also significantly over-expressed in diffuse type and poor differentiation type of GC. DLL4 was significantly over-expressed in advanced T stage, N stage and TNM stage in GC patients. However, the stratified analysis showed that there was no statistically significant difference in Hes1 expression between different subgroups. Sporadic reports showed that Notch1 and Jagged1 were independent poor prognostic predictors in GC.

CONCLUSION: The Notch signaling pathway plays an important role in tumor progression of gastric cancer.

Keywords: Notch, Gastric cancer, Incidence, Prognosis, Meta-analysis

Core tip: This article quantitatively summarizes the evidence for the association between Notch signaling pathway and gastric cancer (GC) by meta-analysis, and finds that Notch1 and Notch2 signaling pathways have been activated in GC; increased expression of Notch1 is associated with non-cardia location, > 5 cm size, diffuse type, positive lymphovascular invasion and distal metastasis; Notch1 and Jagged1 may be independent poor prognostic predictors in GC. Notch signaling may participate in tumor formation and progression of GC.