Augmented expression of Ki-67 is correlated with clinicopathological characteristics and prognosis for lung cancer patients: an up-dated systematic review and meta-analysis with 108 studies and 14,732 patients.
Augmented expression of Ki-67 is correlated with clinicopathological characteristics and prognosis for lung cancer patients: an up-dated systematic review and meta-analysis with 108 studies and 14,732 patients.
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DOI：
10.1186/s12931-018-0843-7
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发表时间：
2018-08-13
影响因子：
5.8
通讯作者：
Chen G
中科院分区：
文献类型：
--
作者：
Wei DM;Chen WJ;Meng RM;Zhao N;Zhang XY;Liao DY;Chen G
肺癌是世界范围内癌症相关死亡的主要原因，我们进行了这项荟萃分析，以调查符合条件的研究并确定Ki-67的预后作用。共有95篇文章的108项研究，14732例患者入选，其中96项研究报告了肺癌患者Ki-67表达与总生存期（OS）的关系，19项研究报告了无病生存期（DFS）的关系。合并危险比（HR）表明，Ki-67水平高可能是肺癌的一个有价值的预后因素（OS的HR = 1.122, P < 0.001， DFS的HR = 1.894, P < 0.001）。结果显示，Ki-67水平高与年龄（奇数比，老年患者OR = 1.246, P = 0.018）、性别（男性OR = 1.874, P < 0.001）、吸烟状况（吸烟者OR = 3.087, P < 0.001）等肺癌临床参数显著相关。此外，Ki-67过表达与较差的分化（OR = 1.993, P = 0.003）、较大的肿瘤大小（OR = 1.436, P = 0.003）和较高的病理分期（III-IV期OR = 1.867, P < 0.001）呈正相关。此外，Ki-67的高表达被发现是淋巴结转移阳性（OR = 1.653, P < 0.001）和TNM晚期（III-IV期OR = 1.497, P = 0.024）的有价值的预测因素。最后，在任何分析中都没有发现发表偏倚。本研究强调，Ki-67的高表达与肺癌的预后和临床病理特征具有临床相关性。然而，需要更多设计良好的前瞻性研究来验证这些发现。本文的在线版本（10.1186/s12931-018-0843-7）包含补充材料，授权用户可以使用。
Lung cancer ranks as the leading cause of cancer-related deaths worldwide and we performed this meta-analysis to investigate eligible studies and determine the prognostic effect of Ki-67. In total, 108 studies in 95 articles with 14,732 patients were found to be eligible, of which 96 studies reported on overall survival (OS) and 19 studies reported on disease-free survival (DFS) with relation to Ki-67 expression in lung cancer patients. The pooled hazard ratio (HR) indicated that a high Ki-67 level could be a valuable prognostic factor for lung cancer (HR = 1.122 for OS, P < 0.001 and HR = 1.894 for DFS, P < 0.001). Subsequently, the results revealed that a high Ki-67 level was significantly associated with clinical parameters of lung cancer including age (odd ratio, OR = 1.246 for older patients, P = 0.018), gender (OR = 1.874 for males, P < 0.001) and smoking status (OR = 3.087 for smokers, P < 0.001). Additionally, significant positive correlations were found between Ki-67 overexpression and poorer differentiation (OR = 1.993, P = 0.003), larger tumor size (OR = 1.436, P = 0.003), and higher pathologic stages (OR = 1.867 for III-IV, P < 0.001). Furthermore, high expression of Ki-67 was found to be a valuable predictive factor for lymph node metastasis positive (OR = 1.653, P < 0.001) and advanced TNM stages (OR = 1.497 for stage III-IV, P = 0.024). Finally, no publication bias was detected in any of the analyses. This study highlights that the high expression of Ki-67 is clinically relevant in terms of the prognostic and clinicopathological characteristics for lung cancer. Nevertheless, more prospective well-designed studies are warranted to validate these findings. The online version of this article (10.1186/s12931-018-0843-7) contains supplementary material, which is available to authorized users.
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