Association between HER-2 and Lymph Node Metastasis in Gastric Cancer: A Meta-Analysis

INTRODUCTION: Human epidermal growth factor receptor 2 (HER-2) in the development of gastric cancer has been widely discussed in the literature. This meta-analysis aimed to assess the relationship between HER-2 and lymph node metastasis in gastric cancer using systematic evaluation and meta-analysis, which can be of some clinical value for treatment and prognosis. METHODS: Relevant databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. PubMed, Embase, Cochrane Library, and Web of Science databases were used to systematically search the literature published up to May 1, 2024. Twenty-one articles were screened and included for quantitative analysis, a data collection form was created, and the quality of the literature was evaluated using the Newcastle-Ottawa Scale (NOS). The results were represented by a Forest plot. I2 was used to assess heterogeneity, Begg's funnel plot was used to test for possible publication bias, and the source of heterogeneity was clarified by the Galbraith plot. Subgroup analyses were performed according to country and test method after excluding studies with significant heterogeneity. All statistical analyses were calculated using stata17.0. This study followed the PRISMA 2020 reporting specifications and the full checklist is available in the online supplementary material (online suppl. Table 4). RESULTS: A total of 624 articles were retrieved, and 21 were selected and included. Meta-analysis showed that there was heterogeneity between HER-2 positive and HER-2 negative mediators in the study (I2 = 68.0%, p < 0.000). Therefore, the 95% CI (3.12, 95% CI: 2.10, 4.65) of the combined OR calculated by the random-effects model was statistically significant. By comparing the incidence of lymph node metastasis between the HER-2 positive group and the HER-2 negative group, it was found that the incidence of lymph node metastasis between the two groups was significantly different. It is suggested that patients with HER-2 overexpression in cancer tissues may be more prone to lymph node metastasis. CONCLUSION: This meta-analysis showed an association between HER-2 and positive lymph node status in gastric cancer patients. This could be valuable for selecting treatment options for gastric cancer patients.