146P - The prognosis value of heat-shock proteins in esophagogastric cancer: A systematic review and meta-analysis

Background

Esophageal cancer is an aggressive cancer with a poor prognosis. Prognostic factors are mainly based on cancer staging. HSPs are molecular chaperones that help protect against stress, often overexpressed in esophageal cancer. However, the prognostic significance and regulatory factors, such as HSF1 and CHIP, are poorly understood. To address the gap, a meta-analysis was conducted to investigate the relationship between HSP expression, prognosis-related factors, and clinicopathological features of esophageal cancer.

Methods

A systematic review was conducted by two reviewers on patients with esophageal cancer until Feb 15 2023. The study compared patients with positive HSP proteins to HSP-negative patients, analyzing grade of differentiation, lymph node metastasis, tumor depth, distant metastasis, and overall survival. HSP were stratified by HSP family, and summary risk difference (RD) were calculated using a random-effect model. Statistical heterogeneity was calculated using I² statistic, and the risk and bias assessment, using the ROBINS-I tool. This study was conducted in accordance with PRISMA statement recommendations.

Results

Final selection comprised 27 studies, with a pooled sample size of 3465 patients. The mean age was 60.7 years old (46-69), with a male predominance. HSP40 and 60 were associated with a higher 3-year overall survival (HSP40 RD: 0.22; 95% CI: 0.09 to 0.35; HSP60 RD: 0.33; 95% CI: 0.17 to 0.50), while HSF1 was associated with a poor 3-year overall survival (RD: -0.22; 95% CI: -0.32 to -0.12). HSF1 was associated with a higher probability of lymph nodal metastasis (RD: -0.16; 95% CI: -0.29 to -0.04). HSP40 was associated with lower probability for lymph nodal dissemination (RD: 0.18; 95% CI: 0.03 to 0.33). HSP were not found to be related to lymph nodal metastasis, tumor depth or distant metastasis. Besides, HSPs were not related to grade of cellular differentiation.

Conclusions

Our systematic review and meta-analysis showed that the expressions of certain families of HSP, such as HSP40 and 60, HSF1 are associated with long-term survival and lymph nodal dissemination in patients with esophageal cancer. These findings support the role of HSP in susceptibility, progression and prognosis in esophageal cancer.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Universidade de São Paulo.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.