title: Prognostic value of hedgehog signaling pathway in digestive system cancers: A systematic review and meta-analysis.
abstract: BACKGROUND
  The Hedgehog (Hh) signaling pathway has recently been reported to be associated with the prognosis of digestive system cancers. However, the results are inconsistent.
  
  
  OBJECTIVE
  This study aimed to investigate the association between Hh pathway components and survival outcomes in patients with digestive system cancers.
  
  
  METHODS
  We conducted a comprehensive retrieval in PubMed, EMBASE and Cochrane library for relevant literatures until May 1st, 2015. The pooled hazard ratios (HRs) for overall survival (OS) and disease-free survival (DFS) with 95% confidence intervals (CIs) were calculated to clarify the prognostic value of Hh pathway components, including Shh, Gli1, Gli2, Smo and Ptch1.
  
  
  RESULTS
  A total of 16 eligible articles with 3222 patients were included in the meta-analysis. Pooled HR suggested that over-expression of Shh and Gli1 were both associated with poor OS (HR = 1.87, 95% CI: 1.14-3.07 and HR = 1.96, 95% CI: 1.66-2.32, respectively) and DFS (HR = 2.37, 95% CI: 1.19-4.72 and HR = 2.18, 95% CI: 1.61-2.96, respectively). In addition, over-expression of Smo was associated with poor DFS (HR = 1.38, 95% CI: 1.08-1.75).
  
  
  CONCLUSIONS
  This study reveals that over-expressed Hh pathway components, including Shh, Gli1 and Smo, are associated with poor prognosis in digestive system cancer patients. Hh signaling pathway may become a potential therapeutic target in digestive system cancers.
authors.affiliation: State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
authors.forename: Yihan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Peng
authors.affiliation: State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
authors.forename: Hongyuan
authors.initials: H
authors.lastname: Jia
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Du
mesh_terms: D015415:Biomarkers; D004067:Digestive System Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000401:mortality*; D015870:Gene Expression; D053823:Hedgehog Proteins / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D015513:Oncogene Proteins / Q000235:genetics / Q000378:metabolism; D011379:Prognosis; D017594:Publication Bias; D043562:Receptors, G-Protein-Coupled / Q000235:genetics / Q000378:metabolism; D015398:Signal Transduction; D000072086:Smoothened Receptor; D015534:Trans-Activators / Q000235:genetics / Q000378:metabolism; D000071676:Zinc Finger Protein GLI1
chemical_list: D015415:Biomarkers; D053823:Hedgehog Proteins; D015513:Oncogene Proteins; D043562:Receptors, G-Protein-Coupled; C491023:SMO protein, human; D000072086:Smoothened Receptor; D015534:Trans-Activators; D000071676:Zinc Finger Protein GLI1
keywords: Hedgehog signaling pathway; digestive system cancers; meta-analysis; prognosis