The Clinical Implications of Chemokine Receptor CXCR4 in Grade and Prognosis of Glioma Patients: A Meta-Analysis.

Chemokine receptor CXCR4 has been identified to affect glioma progression by dominating cancer cell survival, proliferation, and migration in vitro recently. However, the implications and utilities of CXCR4 in clinical grade and prognosis were rarely reported. Thus, it is essential to carry out a meta-analysis to draw a convincing conclusion. The relevant articles were included through careful assessment, and then, odds ratios (ORs), standard mean differences (SMDs), and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were estimated. Heterogeneity and funnel plots evaluation were conducted. In this meta-analysis, all 13 eligible studies involving 785 patients were included and conducted in China. Ten studies revealed altered CXCR4 expression in glioma tissues was closely associated with high WHO grade (III + IV) (n = 10, OR 5.46, 95% CI 3.81-7.84; p = 0.000); besides, six studies also demonstrated CXCR4 expression intensity extremely correlated to high grade (n = 6, SMD -2.45, 95% CI -2.78, -2.12; p = 0.000). Most importantly, three articles identified that CXCR4 expression significantly correlated to 3-year overall survival (OS) (HR 7.32, 95 % CI 4.16-12.90; p = 0.000) in glioma patients. No heterogeneity and publication bias were observed across all studies. Taken together, this meta-analysis suggests CXCR4 expression in gliomas can be recommended as evidence of WHO grade and indeed predict 3-year overall survival. We also provided a scientific rationale for clinically pathological detection of CXCR4 that is required for treatment of glioma patients.