title: Prognostic value of LGR5 in colorectal cancer: a meta-analysis.
abstract: OBJECTIVE
  Leucine-rich repeat-containing G protein-coupled receptor 5 (LGR5) has recently been reported to be a marker of cancer stem cells (CSCs) in colorectal cancer (CRC), and the prognostic value of LGR5 in CRC has been evaluated in several studies. However, the conclusions remain controversial. In this study, we aimed to evaluate the association between the expression of LGR5 and the outcome of CRC patients by performing a meta-analysis.
  
  
  METHODS
  We systematically searched for relevant studies published up to February 2014 using the PubMed, Web of Science, EMBASE and Wangfang databases. Only articles in which LGR5 expression was detected by immunohistochemistry were included. A meta-analysis was performed using STATA 12.0, and pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate the strength of the association between LGR5 expression and the prognosis of CRC patients.
  
  
  RESULTS
  A total of 7 studies comprising 1833 CRC patients met the inclusion criteria, including 6 studies comprising 1781 patients for overall survival (OS) and 3 studies comprising 528 patients for disease-free survival (DFS). Our results showed that high LGR5 expression was significantly associated with poor prognosis in terms of OS (HR: 1.87, 95% CI: 1.23-2.84; P = 0.003) and DFS (HR: 2.44, 95% CI: 1.49-3.98; P<0.001). Further subgroup analysis revealed that many factors, including the study region, number of patients, follow-up duration and cutoff value, affected the significance of the association between LGR5 expression and a worse prognosis in patients with CRC. In addition, there was no evidence of publication bias, as suggested by Begg's and Egger's tests.
  
  
  CONCLUSIONS
  The present meta-analysis indicated that high LGR5 expression was associated with poor prognosis in patients with CRC and that LGR5 is an efficient prognostic factor in CRC.
authors.affiliation: Department of Reproductive Medicine, the First Affiliated Hospital, Xi'an Jiaotong University Medical School, Xi'an, the People's Republic of China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Gynaecology and Obstetrics, the Second Affiliated Hospital, Xi'an Jiaotong University Medical School, Xi'an, the People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Nutrition, the First Affiliated Hospital, Xi'an Jiaotong University Medical School, Xi'an, the People's Republic of China.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Li
authors.affiliation: Institute of Cardiovascular research, the First Hospital of Xi'an, Xi'an, the People's Republic of China.
authors.forename: Yu-Qiang
authors.initials: YQ
authors.lastname: Ji
authors.affiliation: Department of Reproductive Medicine, the First Affiliated Hospital, Xi'an Jiaotong University Medical School, Xi'an, the People's Republic of China.
authors.forename: Hao-Zhe
authors.initials: HZ
authors.lastname: Cao
authors.affiliation: Department of Reproductive Medicine, the First Affiliated Hospital, Xi'an Jiaotong University Medical School, Xi'an, the People's Republic of China.
authors.forename: Pengsheng
authors.initials: P
authors.lastname: Zheng
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D006801:Humans; D011237:Predictive Value of Tests; D011379:Prognosis; D043562:Receptors, G-Protein-Coupled / Q000032:analysis / Q000378:metabolism; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; C116884:LGR5 protein, human; D043562:Receptors, G-Protein-Coupled