OBJECTIVE The expression and significance of human epidermal growth factor receptor 2 (Her2) in upper tract urothelial carcinoma (UTUC) remains controversial. Thus, we aimed to systemically review the Her2 expression in UTUC patients and its relationship with pathological characters and clinical outcomes with meta-analysis. MATERIALS AND METHODS A systematically computerized search in PubMed, Scopus, Embase and Cochrane was conducted. From a total of 454 related articles, 35 articles were finally reviewed and 16 papers were chosen for further analysis. Pathological characters included tumor stage, grade, lymph node metastasis (LNM) and lymphovascular invasion (LVI). The clinical outcomes included overall survival (OS), recurrence-free survival (RFS), cancer specific survival (CSS), metastatic-free survival (MFS) and progression-free survival (PFS). RevMan software was used for meta-analyses. RESULTS In total 16 studies from 1994 to 2020 were chosen, 14 studies used immunohistochemistry to assess the expression of Her2 and 5 studies used in situ hybridization, with a positive rate of 0 to 74.0% and 7.2 to 18.1%, respectively. Her2-positive was significantly associated with stage (pooled HR 1.86; 95 % CI 1.43-2.42), grade (pooled HR 2.81; 95 % CI 1.01-7.85) and LNM (pooled HR 1.93; 95 % CI 1.18-3.15). However, there was no statistically relationship between Her2-positive with LVI (pooled HR 1.48; 95 % CI 0.64-3.46) and RFS (pooled HR 1.41; 95 % CI 0.98-1.83). CONCLUSIONS This review indicated that UTUC patients with Her2-positive tended to develop higher stage and grade tumors and LNM. The Her2 expression in UTUC patients deserves further investigation in the future.

中文翻译：

---

对上尿路尿路上皮癌患者的人表皮生长因子受体 2 进行系统回顾和荟萃分析。

目的 人表皮生长因子受体2（Her2）在上尿路尿路上皮癌（UTUC）中的表达和意义仍存在争议。因此，我们旨在通过荟萃分析系统回顾UTUC患者中Her2的表达及其与病理特征和临床结果的关系。材料和方法 在 PubMed、Scopus、Embase 和 Cochrane 中进行了系统的计算机化检索。从总共454篇相关文章中，最终审阅了35篇文章，并选择了16篇论文进行进一步分析。病理特征包括肿瘤分期、分级、淋巴结转移（LNM）和淋巴管侵犯（LVI）。临床结果包括总生存期（OS）、无复发生存期（RFS）、癌症特异性生存期（CSS）、无转移生存期（MFS）和无进展生存期（PFS）。RevMan 软件用于荟萃分析。结果 共纳入1994年至2020年的16项研究，其中14项采用免疫组化检测Her2表达，5项采用原位杂交，阳性率分别为0～74.0%和7.2～18.1%。Her2 阳性与分期（汇总 HR 1.86；95% CI 1.43-2.42）、分级（汇总 HR 2.81；95% CI 1.01-7.85）和 LNM（汇总 HR 1.93；95% CI 1.18-3.15）显着相关。然而，Her2 阳性与 LVI（汇总 HR 1.48；95% CI 0.64-3.46）和 RFS（汇总 HR 1.41；95% CI 0.98-1.83）之间没有统计学关系。结论 本综述表明，Her2 阳性的 UTUC 患者往往会出现较高阶段和级别的肿瘤和 LNM。UTUC 患者中 Her2 的表达值得进一步研究。