The prognostic value of myeloid derived suppressor cell level in hepatocellular carcinoma: A systematic review and meta-analysis
Many studies have investigated the association between the level of myeloid derived suppressor cells (MDSCs) and clinical features and prognosis of hepatocellular carcinoma (HCC), but the results remain controversial. This systematic review and meta-analysis was conducted to summarize all available...
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| description | Many studies have investigated the association between the level of myeloid derived suppressor cells (MDSCs) and clinical features and prognosis of hepatocellular carcinoma (HCC), but the results remain controversial. This systematic review and meta-analysis was conducted to summarize all available data and estimate the relationship.
A comprehensive literature review was carried out using Medline, Embase and Web of Science database through December 2018 to identify relevant studies. The standardized mean difference (SMD) and the hazard ratio (HR) with 95% confidence interval (CI) were utilized for evaluating continuous outcomes and survival analysis, respectively. All statistical analyses were performed by STATA 14.0 software.
A total of 13 studies with 1002 HCC patients were included in the meta-analysis. Overall, the proportion of MDSCs in HCC patients was higher than that in healthy controls (SMD = 4.49, 95% CI = 2.53-6.46, P |
| doi_str_mv | 10.1371/journal.pone.0225327 |
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A comprehensive literature review was carried out using Medline, Embase and Web of Science database through December 2018 to identify relevant studies. The standardized mean difference (SMD) and the hazard ratio (HR) with 95% confidence interval (CI) were utilized for evaluating continuous outcomes and survival analysis, respectively. All statistical analyses were performed by STATA 14.0 software.
A total of 13 studies with 1002 HCC patients were included in the meta-analysis. Overall, the proportion of MDSCs in HCC patients was higher than that in healthy controls (SMD = 4.49, 95% CI = 2.53-6.46, P<0.001), and patients with chronic liver disease (SMD = 3.41, 95% CI = 1.58-5.24, P<0.001). Subgroup analysis based on the phenotypes of MDSCs and geographical areas showed similar results. However, the frequency of MDSCs was not affected by the treatment with conventional approaches for HCC (SMD = -0.25, 95% CI = -0.57-0.06, P = 0.119). Moreover, increased MDSCs level was significantly associated with poorer overall survival (HR = 2.36, 95% CI = 1.70-3.29, P<0.001) and recurrence-free survival (HR = 2.72, 95% CI = 1.70-4.35, P<0.001), but not significantly correlated with any clinicopathological parameters.
The results of this systematic review suggest that elevated MDSCs level appears to be associated with an increased risk for disease progression and poor prognosis for HCC.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0225327</identifier><identifier>PMID: 31790437</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Biomarkers, Tumor ; Cancer ; Cancer therapies ; Carcinoma ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - therapy ; Confidence intervals ; Development and progression ; Disease Progression ; Disease-Free Survival ; Health risks ; Hepatitis ; Hepatocellular carcinoma ; Humans ; Literature reviews ; Liver ; Liver cancer ; Liver diseases ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - therapy ; Medical ethics ; Medical prognosis ; Medical research ; Medicine and Health Sciences ; Meta-analysis ; Myeloid-Derived Suppressor Cells - pathology ; Neoplasm Recurrence, Local ; Online databases ; Patients ; Phenotype ; Phenotypes ; Physical Sciences ; Prognosis ; Research and Analysis Methods ; Risk ; Science Policy ; Sorafenib ; Statistical analysis ; Studies ; Subgroups ; Suppressor cells ; Survival ; Systematic review</subject><ispartof>PloS one, 2019-12, Vol.14 (12), p.e0225327</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Zhang et al 2019 Zhang et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-7f71045262e3f4406bd73bc19be7c6eab1f1e937d66862060e68896f4dae3bf63</citedby><cites>FETCH-LOGICAL-c692t-7f71045262e3f4406bd73bc19be7c6eab1f1e937d66862060e68896f4dae3bf63</cites><orcidid>0000-0003-3158-2536</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886785/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886785/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31790437$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Hsieh, Jason Chia-Hsun</contributor><creatorcontrib>Zhang, Xinyu</creatorcontrib><creatorcontrib>Fu, Xin</creatorcontrib><creatorcontrib>Li, Tianyu</creatorcontrib><creatorcontrib>Yan, Huimin</creatorcontrib><title>The prognostic value of myeloid derived suppressor cell level in hepatocellular carcinoma: A systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Many studies have investigated the association between the level of myeloid derived suppressor cells (MDSCs) and clinical features and prognosis of hepatocellular carcinoma (HCC), but the results remain controversial. This systematic review and meta-analysis was conducted to summarize all available data and estimate the relationship.
A comprehensive literature review was carried out using Medline, Embase and Web of Science database through December 2018 to identify relevant studies. The standardized mean difference (SMD) and the hazard ratio (HR) with 95% confidence interval (CI) were utilized for evaluating continuous outcomes and survival analysis, respectively. All statistical analyses were performed by STATA 14.0 software.
A total of 13 studies with 1002 HCC patients were included in the meta-analysis. Overall, the proportion of MDSCs in HCC patients was higher than that in healthy controls (SMD = 4.49, 95% CI = 2.53-6.46, P<0.001), and patients with chronic liver disease (SMD = 3.41, 95% CI = 1.58-5.24, P<0.001). Subgroup analysis based on the phenotypes of MDSCs and geographical areas showed similar results. However, the frequency of MDSCs was not affected by the treatment with conventional approaches for HCC (SMD = -0.25, 95% CI = -0.57-0.06, P = 0.119). Moreover, increased MDSCs level was significantly associated with poorer overall survival (HR = 2.36, 95% CI = 1.70-3.29, P<0.001) and recurrence-free survival (HR = 2.72, 95% CI = 1.70-4.35, P<0.001), but not significantly correlated with any clinicopathological parameters.
The results of this systematic review suggest that elevated MDSCs level appears to be associated with an increased risk for disease progression and poor prognosis for HCC.</description><subject>Analysis</subject><subject>Biomarkers, Tumor</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Carcinoma</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>Confidence intervals</subject><subject>Development and progression</subject><subject>Disease Progression</subject><subject>Disease-Free Survival</subject><subject>Health risks</subject><subject>Hepatitis</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Literature reviews</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver diseases</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - therapy</subject><subject>Medical ethics</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Myeloid-Derived Suppressor Cells - pathology</subject><subject>Neoplasm Recurrence, Local</subject><subject>Online databases</subject><subject>Patients</subject><subject>Phenotype</subject><subject>Phenotypes</subject><subject>Physical Sciences</subject><subject>Prognosis</subject><subject>Research and Analysis Methods</subject><subject>Risk</subject><subject>Science Policy</subject><subject>Sorafenib</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Subgroups</subject><subject>Suppressor cells</subject><subject>Survival</subject><subject>Systematic review</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk81u1DAQxyMEoqXwBggsISE47OKPxE44IFUVH5UqVYLC1Zokk11XTpzaycIeeROehSfDYdOqi3pAPtga_-Y_H_YkyVNGl0wo9ubSjb4Du-xdh0vKeSa4upccskLwheRU3L91PkgehXBJaSZyKR8mB4KpgqZCHSY_L9ZIeu9WnQuDqcgG7IjENaTdonWmJjV6s8GahLHvPYbgPKnQWmJxg5aYjqyxh8FNttFCvARfmc618JYc__4VtmHAFiZljxuD3wl0NWlxgAXE5LfBhMfJgwZswCfzfpR8_fD-4uTT4uz84-nJ8dmikgUfFqpRjKYZlxxFk6ZUlrUSZcWKElUlEUrWMCyEqqXMY8mSoszzQjZpDSjKRoqj5PlOt7cu6Ll7QXPBaS5YkdJInO6I2sGl7r1pwW-1A6P_GpxfafCxFIu6UhIyxgTQrEiZKAtATjlmOdacFrKMWu_maGPZYl1hN3iwe6L7N51Z65Xb6Ji1VHkWBV7NAt5djRgG3ZowdRk6dOOct-K5nNAX_6B3VzdTK4gFmK5xMW41iepjSZXIVE55pJZ3UHHV2JoqfrXGRPuew-s9h8gM-GNYwRiCPv3y-f_Z82_77Mtb7BrBDuvg7DgY14V9MN2BlXcheGxumsyonibluht6mhQ9T0p0e3b7gW6crkdD_AHFlhA_</recordid><startdate>20191202</startdate><enddate>20191202</enddate><creator>Zhang, Xinyu</creator><creator>Fu, Xin</creator><creator>Li, Tianyu</creator><creator>Yan, Huimin</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-3158-2536</orcidid></search><sort><creationdate>20191202</creationdate><title>The prognostic value of myeloid derived suppressor cell level in hepatocellular carcinoma: A systematic review and meta-analysis</title><author>Zhang, Xinyu ; Fu, Xin ; Li, Tianyu ; Yan, Huimin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-7f71045262e3f4406bd73bc19be7c6eab1f1e937d66862060e68896f4dae3bf63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Analysis</topic><topic>Biomarkers, Tumor</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Carcinoma</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - therapy</topic><topic>Confidence intervals</topic><topic>Development and progression</topic><topic>Disease Progression</topic><topic>Disease-Free Survival</topic><topic>Health risks</topic><topic>Hepatitis</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Literature reviews</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver diseases</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - therapy</topic><topic>Medical ethics</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Meta-analysis</topic><topic>Myeloid-Derived Suppressor Cells - pathology</topic><topic>Neoplasm Recurrence, Local</topic><topic>Online databases</topic><topic>Patients</topic><topic>Phenotype</topic><topic>Phenotypes</topic><topic>Physical Sciences</topic><topic>Prognosis</topic><topic>Research and Analysis Methods</topic><topic>Risk</topic><topic>Science Policy</topic><topic>Sorafenib</topic><topic>Statistical analysis</topic><topic>Studies</topic><topic>Subgroups</topic><topic>Suppressor cells</topic><topic>Survival</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Xinyu</creatorcontrib><creatorcontrib>Fu, Xin</creatorcontrib><creatorcontrib>Li, Tianyu</creatorcontrib><creatorcontrib>Yan, Huimin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Xinyu</au><au>Fu, Xin</au><au>Li, Tianyu</au><au>Yan, Huimin</au><au>Hsieh, Jason Chia-Hsun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prognostic value of myeloid derived suppressor cell level in hepatocellular carcinoma: A systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-12-02</date><risdate>2019</risdate><volume>14</volume><issue>12</issue><spage>e0225327</spage><pages>e0225327-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Many studies have investigated the association between the level of myeloid derived suppressor cells (MDSCs) and clinical features and prognosis of hepatocellular carcinoma (HCC), but the results remain controversial. This systematic review and meta-analysis was conducted to summarize all available data and estimate the relationship.
A comprehensive literature review was carried out using Medline, Embase and Web of Science database through December 2018 to identify relevant studies. The standardized mean difference (SMD) and the hazard ratio (HR) with 95% confidence interval (CI) were utilized for evaluating continuous outcomes and survival analysis, respectively. All statistical analyses were performed by STATA 14.0 software.
A total of 13 studies with 1002 HCC patients were included in the meta-analysis. Overall, the proportion of MDSCs in HCC patients was higher than that in healthy controls (SMD = 4.49, 95% CI = 2.53-6.46, P<0.001), and patients with chronic liver disease (SMD = 3.41, 95% CI = 1.58-5.24, P<0.001). Subgroup analysis based on the phenotypes of MDSCs and geographical areas showed similar results. However, the frequency of MDSCs was not affected by the treatment with conventional approaches for HCC (SMD = -0.25, 95% CI = -0.57-0.06, P = 0.119). Moreover, increased MDSCs level was significantly associated with poorer overall survival (HR = 2.36, 95% CI = 1.70-3.29, P<0.001) and recurrence-free survival (HR = 2.72, 95% CI = 1.70-4.35, P<0.001), but not significantly correlated with any clinicopathological parameters.
The results of this systematic review suggest that elevated MDSCs level appears to be associated with an increased risk for disease progression and poor prognosis for HCC.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31790437</pmid><doi>10.1371/journal.pone.0225327</doi><tpages>e0225327</tpages><orcidid>https://orcid.org/0000-0003-3158-2536</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Biomarkers, Tumor Cancer Cancer therapies Carcinoma Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - therapy Confidence intervals Development and progression Disease Progression Disease-Free Survival Health risks Hepatitis Hepatocellular carcinoma Humans Literature reviews Liver Liver cancer Liver diseases Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - therapy Medical ethics Medical prognosis Medical research Medicine and Health Sciences Meta-analysis Myeloid-Derived Suppressor Cells - pathology Neoplasm Recurrence, Local Online databases Patients Phenotype Phenotypes Physical Sciences Prognosis Research and Analysis Methods Risk Science Policy Sorafenib Statistical analysis Studies Subgroups Suppressor cells Survival Systematic review |
| title | The prognostic value of myeloid derived suppressor cell level in hepatocellular carcinoma: A systematic review and meta-analysis |
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