title: Prognostic Role of Secretory Clusterin in Multiple Human Malignant Neoplasms: A Meta-Analysis of 26 Immunohistochemistry Studies.
abstract: Secretory clusterin (sCLU) is a potential prognostic tumour biomarker, but results of different sCLU studies are inconsistent. We conducted this meta-analysis to evaluate the precise predictive value of sCLU. Qualified studies were identified by performing online searches in PubMed, EMBASE, and Web of Science. The selected articles were divided into three groups based on scoring method for clusterin detection. Pooled hazard ratios (HRs) with 95% confidence interval (CI) for patient survival and disease recurrence were calculated to determine the correlation between sCLU expression and cancer prognosis. Heterogeneity was assessed using I2 statistics, and specific heterogeneity in different groups was analysed. Elevated sCLU was significantly associated with recurrence-free survival in groups 1 and 3 (group 1: pooled HR = 1.35, 95% CI = 1.01 to 1.79; group 3: pooled HR = 1.80, 95% CI = 1.22 to 2.65). However, clusterin expression was not associated with overall survival in all three groups. Results showed that only the heterogeneity of group 2 was very strong (p = 0.013, I2 = 76.3%), in which the specimens were scored through sCLU staining intensity only. sCLU is a potential biomarker for tumour prognosis, and IHC methods can be more standardised if both intensity and staining proportion are considered.
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Chenkui
authors.initials: C
authors.lastname: Miao
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Aiming
authors.initials: A
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhao
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Qin
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Liang
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Yibo
authors.initials: Y
authors.lastname: Hua
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Yiyang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Shifeng
authors.initials: S
authors.lastname: Su
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Zengjun
authors.initials: Z
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
authors.forename: Bianjiang
authors.initials: B
authors.lastname: Liu
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D051152:Clusterin / Q000378:metabolism*; D018572:Disease-Free Survival; D006801:Humans; D007150:Immunohistochemistry; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; C495242:CLU protein, human; D051152:Clusterin