title: The clinical association of programmed cell death protein 4 (PDCD4) with solid tumors and its prognostic significance: a meta-analysis.
abstract: BACKGROUND
  Programmed cell death protein 4 (PDCD4) is a novel tumor suppressor protein involved in programmed cell death. Its association with cancer progression has been observed in multiple tumor models, but evidence supporting its association with solid tumors in humans remains controversial. This study aimed to determine the clinical significance and prognostic value of PDCD4 in solid tumors.
  
  
  METHODS
  A systematic literature review was performed to retrieve publications with available clinical information and survival data. The eligibility of the selected articles was based on the criteria of the Dutch Cochrane Centre proposed by the Meta-analysis Of Observational Studies in Epidemiology group. Pooled odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) for survival analysis were calculated. Publication bias was examined by Begg's and Egger's tests.
  
  
  RESULTS
  Clinical data of 2227 cancer patients with solid tumors from 23 studies were evaluated. PDCD4 expression was significantly associated with the differentiation status of head and neck cancer (OR 4.25, 95% CI 1.87-9.66) and digestive system cancer (OR 2.87, 95% CI 1.84-4.48). Down-regulation of PDCD4 was significantly associated with short overall survival of patients with head and neck (HR: 3.44, 95% CI 2.38-4.98), breast (HR: 1.86, 95% CI 1.36-2.54), digestive system (HR: 2.12, 95% CI 1.75-2.56), and urinary system cancers (HR: 3.16, 95% CI 1.06-9.41).
  
  
  CONCLUSIONS
  The current evidence suggests that PDCD4 down-regulation is involved in the progression of several types of solid tumor and is a potential marker for solid tumor prognoses. Its clinical usefulness should be confirmed by large-scale prospective studies.
authors.affiliation: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong, SAR, P. R. China.
authors.forename: John Zeng Hong
authors.initials: JZ
authors.lastname: Li
authors.affiliation: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong, SAR, P. R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong, SAR, P. R. China.
authors.forename: Wai-Kuen
authors.initials: WK
authors.lastname: Ho
authors.affiliation: Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 510080, P. R. China.
authors.forename: Wen Bin
authors.initials: WB
authors.lastname: Lei
authors.affiliation: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong, SAR, P. R. China.
authors.forename: William Ignace
authors.initials: WI
authors.lastname: Wei
authors.affiliation: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong, SAR, P. R. China.
authors.forename: Jimmy Yu-Wai
authors.initials: JY
authors.lastname: Chan
authors.affiliation: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong, SAR, P. R. China. thiansze@gmail.com.
authors.forename: Thian-Sze
authors.initials: TS
authors.lastname: Wong
mesh_terms: D051017:Apoptosis Regulatory Proteins / Q000235:genetics / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D018450:Disease Progression; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D009369:Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D016601:RNA-Binding Proteins / Q000235:genetics / Q000378:metabolism*
chemical_list: D051017:Apoptosis Regulatory Proteins; D014408:Biomarkers, Tumor; C114487:PDCD4 protein, human; D016601:RNA-Binding Proteins
keywords: Disease-free survival; Meta-analysis; Overall survival; Prognosis; Programmed cell death protein 4 (PDCD4); Recurrence-free survival; Solid tumor