title: Prognostic significance of EBV latent membrane protein 1 expression in lymphomas: evidence from 15 studies.
abstract: BACKGROUND
  Epstein-Barr virus (EBV) infection has been associated with lymphoma development. EBV latent membrane protein 1 (LMP1) is essential for EBV-mediated transformation and progression of different human cells, including lymphocytes. This meta-analysis investigated LMP1 expression with prognosis of patients with lymphoma.
  
  
  METHODS
  The electronic databases of PubMed, Embase, and Chinese Biomedicine Databases were searched. There were 15 published studies available for a random effects model analysis. Quality assessment was performed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies. A funnel plot was used to investigate publication bias, and sources of heterogeneity were identified by meta-regression analysis. The combined hazard ratios (HR) and their corresponding 95% confidence intervals of LMP1 expression were calculated by comparison to the overall survival.
  
  
  RESULTS
  Overall, there was no statistical significance found between LMP1 expression and survival of lymphoma patients (HR 1.25 [95% CI, 0.92-1.68]). In subgroup analyses, LMP1 expression was associated with survival in patients with non-Hodgkin lymphoma (NHL) (HR = 1.84, 95% CI: 1.02-3.34), but not with survival of patients with Hodgkin disease (HD) (HR = 1.03, 95% CI: 0.74-1.44). In addition, significant heterogeneity was present and the meta-regression revealed that the outcome of analysis was mainly influenced by the cutoff value.
  
  
  CONCLUSIONS
  This meta-analysis demonstrated that LMP1 expression appears to be an unfavorable prognostic factor for overall survival of NHL patients. The data suggested that EBV infection and LMP1 expression may be an important factor for NHL development or progression.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Jiangsu Province Official Hospital, Nanjing, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Mao
authors.forename: Mei Ping
authors.initials: MP
authors.lastname: Lu
authors.forename: Hong
authors.initials: H
authors.lastname: Lin
authors.forename: Da Wei
authors.initials: DW
authors.lastname: Zhang
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Qing Dong
authors.initials: QD
authors.lastname: Li
authors.forename: Zhi Gang
authors.initials: ZG
authors.lastname: Lv
authors.forename: Jia Ren
authors.initials: JR
authors.lastname: Xu
authors.forename: Ren Jie
authors.initials: RJ
authors.lastname: Chen
authors.forename: Jin
authors.initials: J
authors.lastname: Zhu
mesh_terms: D016001:Confidence Intervals; D006801:Humans; D008223:Lymphoma / Q000378:metabolism* / Q000821:virology*; D011379:Prognosis; D016016:Proportional Hazards Models; D017594:Publication Bias; D012044:Regression Analysis; D014763:Viral Matrix Proteins / Q000378:metabolism*
chemical_list: C037662:EBV-associated membrane antigen, Epstein-Barr virus; D014763:Viral Matrix Proteins