Expression of HER-2 in surgical specimen and biopsy as a biomarker of metastasis in patients with osteosarcoma: a meta-analysis

BACKGROUND: Previous studies have evaluated the effect of human epidermal growth factor receptor 2 (HER-2) expression on the metastasis of patients with osteosarcoma (OS) while the results remain conflicting. Here we performed a systematic review and meta-analysis to determine the value of HER-2 in prognosis of OS. METHODS: A comprehensive search using NCBI PubMed, the Cochrane library, Embase, ISI Web of Knowledge, Springer, China National Knowledge Internet database (CNKI), Wanfang database, Chinese VIP database and Chinese Biological Medical Database (CBM) from inception through Aug 28, 2018 was conducted to investigate HER-2 expression and OS metastasis. We evaluated the quantity of the studies using Newcastle-Ottawa quality assessment scale (NOS). RESULTS: There were 15 studies with 652 OS patients involved. The results of meta-analysis showed that positive expression of HER-2 was associated with OS metastasis (OR =4.42; 95% CI, 2.91–6.71; P<0.0001). No significant heterogeneity or publication bias was observed among all studies. CONCLUSIONS: The results of this study suggest that HER-2 positive expression indicates OS metastasis, while it’s needed to perform more prospective studies to confirm the prognostic value of HER-2 in patients with OS.