Pancreaticobiliary Maljunction Is Associated with Common Bile Duct Carcinoma: A Meta-Analysis

Objective. Pancreaticobiliary maljunction (PBM) has been reported to be associated with an increased risk of gallbladder carcinoma. However, the relationship between PBM and common bile duct carcinoma (CBDC) remains unclear. We aimed to conduct a meta-analysis to determine the available evidence on the association between PBM and CBDC. Methods. The pooled odds ratio (OR) and standard mean differences (SMD) with 95% confidence interval (95% CI) were used to estimate the effects. Results. A total of eight case-control studies and two cohort studies were identified. The incidence of PBM was higher in CBDC patients than in controls (OR=1.45; 95% CI, 1.19–1.76). Compared with patients without PBM, CBDC patients with PBM were younger at the diagnosis age (SMD=−0.46; 95% CI, −0.64 to −0.28). A difference in the incidence of associated CDC was found between CBDC patients with or without PBM (OR=2.14; 95% CI, 1.60–2.87). Conclusions. Compared with benign biliary tract diseases, the incidence of PBM was higher in CBDC patients, especially in relatively young patients. We also found that the incidence of CDC was higher in CBDC patients with PBM. These findings showed positive association between PBM and CBDC, which may help in identifying high-risk individuals

Pancreaticobiliary maljunction is associated with common bile duct carcinoma: a meta-analysis. ScientificWorldJournal 2013;2013:618670

Objective. Pancreaticobiliary maljunction (PBM) has been reported to be associated with an increased risk of gallbladder carcinoma. However, the relationship between PBM and common bile duct carcinoma (CBDC) remains unclear. We aimed to conduct a metaanalysis to determine the available evidence on the association between PBM and CBDC. Methods. The pooled odds ratio (OR) and standard mean differences (SMD) with 95% confidence interval (95% CI) were used to estimate the effects. Results. A total of eight case-control studies and two cohort studies were identified. The incidence of PBM was higher in CBDC patients than in controls (OR = 1.45; 95% CI, 1.19-1.76). Compared with patients without PBM, CBDC patients with PBM were younger at the diagnosis age (SMD = −0.46; 95% CI, −0.64 to −0.28). A difference in the incidence of associated CDC was found between CBDC patients with or without PBM (OR = 2.14; 95% CI, 1.60-2.87). Conclusions. Compared with benign biliary tract diseases, the incidence of PBM was higher in CBDC patients, especially in relatively young patients. We also found that the incidence of CDC was higher in CBDC patients with PBM. These findings showed positive association between PBM and CBDC, which may help in identifying high-risk individuals

Prognostic Significance of Cyclin D1 Expression in Colorectal Cancer: A Meta-Analysis of Observational Studies

<div><p>Objective</p><p>Cyclin D1 plays a vital role in cancer cell cycle progression and is overexpressed in many human cancers, including colorectal cancer (CRC). However, the prognostic value of cyclin D1 overexpression in colorectal cancer is conflicting and heterogeneous. We conducted a meta-analysis to more precisely evaluate its prognostic significance.</p><p>Methods</p><p>A comprehensive literature search for relevant studies published up to January 2014 was performed using PubMed, EMBASE, and ISI Web of Science. The pooled hazard ratio (HR) with 95% confidence intervals (CI) was used to estimate the effects.</p><p>Results</p><p>22 studies with 4150 CRC patients were selected to evaluate the association between cyclin D1 and overall survival (OS), disease-free survival (DFS) and clinicopathological parameters. In a random-effects model, the results showed that cyclin D1 overexpression in CRC was significantly associated with both poor OS (HR = 0.73, 95% CI: 0.63–0.85, <i>P</i><0.001) and DFS (HR = 0.60, 95% CI: 0.44–0.82, <i>P</i> = 0.001). Additionally, cyclin D1 overexpression was significantly associated with more relative older patients (≥60 years) (OR 0.62, 95% CI 0.44–0.89, <i>P</i> = 0.009), T3,4 tumor invasion (OR 0.70, 95% CI 0.57–0.85, <i>P</i><0.001), N positive (OR 0.75, 95% CI 0.60–0.95, <i>P</i> = 0.016) and distant metastasis (OR 0.60, 95% CI 0.36–0.99, <i>P</i> = 0.047) of CRC.</p><p>Conclusion</p><p>The meta-analysis results indicated that cyclin D1 is an unfavorable prognostic factor for CRC. Cyclin D1 overexpression might be associated with poor clinical outcome and some clinicopathological factors such as age, T category, N category and distant metastasis in CRC patients.</p></div

Flow diagram of screened, excluded, and analyzed publications.

<p>Flow diagram of screened, excluded, and analyzed publications.</p

Sensitivity analysis based on stepwise omitting one study at a time for overall survival (OS).

<p>Sensitivity analysis based on stepwise omitting one study at a time for overall survival (OS).</p

Forest plot of the hazard ratio (HR) for the association of cyclin D1 expression with disease-free survival (DFS).

<p>Forest plot of the hazard ratio (HR) for the association of cyclin D1 expression with disease-free survival (DFS).</p

Begg's funnel plot for the evaluation of potential publication bias on overall estimate of disease-free survival (DFS).

<p>Begg's funnel plot for the evaluation of potential publication bias on overall estimate of disease-free survival (DFS).</p

Results of overall and subgroup analyses for effects of cyclin D1 expression on overall and disease-free survival in colorectal cancer.

<p>Abbreviations: HR: hazard ratio; 95% CI: 95% confidence interval; N: number of studies.</p

Characteristics of studies included in the meta-analysis.

<p>*these studies looked back at medical records and did not report the time of follow-up.</p><p>Abbreviations: BMI: body mass index; CA19-9: carbohydrate antigen 19-9; CEA: carcinoembryonic antigen; CIMP: the CpG island methylator phenotype; CK-19: cytokeratin-19; COX-2: cyclooxygenase-2; CRC: colorectal cancer; DFS, disease-free survival; FASN: fatty acid synthase; HR: hazard ratio; LINE-1: long interspersed nucleotide element-1; MMP-7: matrix metalloproteinase-7; MSI: microsatellite instability; NA: not available; OS: overall survival; pRb: retinoblastoma protein; PRL: prolactin; P-Stat5: phosphorylated signal transducer and activator of transcription-5; VEGF: vascular endothelial growth factor; YAP: Yes-associated protein.</p