title: The Prognostic Impact of Heat Shock Proteins Expression in Patients with Esophageal Cancer: A Meta-Analysis.
abstract: OBJECTIVE
  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.
  
  
  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).
  
  
  CONCLUSIONS
  In this meta-analysis, reduced HSP27 and HSP70 expressions were associated with poor survival in patients with esophageal cancer, especially esophageal squamous cell carcinoma.
authors.affiliation: Department of Medical Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, Korea.
authors.forename: Xiao-wei
authors.initials: XW
authors.lastname: Wang
authors.affiliation: Department of Laboratory Medicine, Yancheng First People's Hospital, Yancheng, Jiangsu, Korea.
authors.forename: Xin-hui
authors.initials: XH
authors.lastname: Shi
authors.affiliation: Department of Medical Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, Korea.
authors.forename: Yu-suo
authors.initials: YS
authors.lastname: Tong
authors.affiliation: Department of Surgical Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, P.R. China. cxf551101@sina.com.
authors.forename: Xiu-feng
authors.initials: XF
authors.lastname: Cao
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism* / Q000401:mortality; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D000077277:Esophageal Squamous Cell Carcinoma; D015972:Gene Expression Regulation, Neoplastic; D055551:HSP27 Heat-Shock Proteins; D018840:HSP70 Heat-Shock Proteins; D018841:HSP90 Heat-Shock Proteins; D006360:Heat-Shock Proteins / Q000378:metabolism*; D006801:Humans; D008297:Male; D009363:Neoplasm Proteins; D011379:Prognosis; D013534:Survival; D016896:Treatment Outcome
chemical_list: D055551:HSP27 Heat-Shock Proteins; D018840:HSP70 Heat-Shock Proteins; D018841:HSP90 Heat-Shock Proteins; D006360:Heat-Shock Proteins; D009363:Neoplasm Proteins
keywords: HSP27; HSP70; HSP90; esophageal cancer; meta-analysis; survival