Luo Guanying, Hu Yunzhao, Zhang Zhiqiao, Wang Peng, Luo Zhaowen, Lin Jinxin, Cheng Canchang, Yang You
Department of Infectious Diseases, The First People's Hospital of Shunde, Shunde, Guangdong, China.
Department of Internal Medicine, The Chencun Affiliated Hospital of First People's Hospital of Shunde, Shunde, Guangdong, China.
Oncotarget. 2017 Jul 25;8(30):50273-50283. doi: 10.18632/oncotarget.17305.
The prognostic value and clinicopathologic significance of Ki-67 expression in gastric cancer patients was controversial. This meta-analysis was performed to clarify the prognostic value and clinicopathologic significance of Ki-67 expression in gastric cancer patients.
Several electronic databases were searched for eligible studies. The pooled odds ratio (OR), hazard ratios (HR) and 95% confidence interval(CI) were calculated to explore the prognostic value and clinicopathologic significance of Ki-67 expression for disease free survival and overall survival.
Totally 5600 gastric cancer patients from 29 studies were included in this study. High Ki-67 expression was significantly related with Lauren's classification (OR = 1.70; P = 0.001; 95%CI: 1.40-2.06) and tumor size(OR = 1.54; P = 0.006; 95%CI: 1.14-2.09). However, high Ki-67 expression was not significantly associated with lymph node metastasis (OR = 1.37; P = 0.138; 95% CI: 0.90-2.08) , tumor stage (OR = 1.31; P = 0.296; 95% CI: 0.79-2.16) and tumor differentiation (OR = 1.03; P = 0.839; 95% CI: 0.78-1.35). The pooled HRs were 1.87(P = 0.001; 95% CI 1.30-2.69) for disease free survival and 1.23(P = 0.005; 95% CI 1.06-1.42) for overall survival.
High Ki-67 expression may serve as a predictive biomarker for poor prognosis in gastric cancer patients. Stratification by Ki-67 expression may be a consideration for selection of therapeutic regimen and integrated managements.
Ki-67表达在胃癌患者中的预后价值及临床病理意义存在争议。本荟萃分析旨在阐明Ki-67表达在胃癌患者中的预后价值及临床病理意义。
检索多个电子数据库以获取符合条件的研究。计算合并比值比（OR）、风险比（HR）及95%置信区间（CI），以探讨Ki-67表达对无病生存期和总生存期的预后价值及临床病理意义。
本研究共纳入来自29项研究的5600例胃癌患者。Ki-67高表达与 Lauren分型（OR = 1.70；P = 0.001；95%CI：1.40 - 2.06）及肿瘤大小（OR = 1.54；P = 0.006；95%CI：1.14 - 2.09）显著相关。然而，Ki-67高表达与淋巴结转移（OR = 1.37；P = 0.138；95%CI：0.90 - 2.08）、肿瘤分期（OR = 1.31；P = 0.296；95%CI：0.79 - 2.16）及肿瘤分化（OR = 1.03；P = 0.839；95%CI：0.78 - 1.35）无显著相关性。无病生存期的合并HR为1.87（P = 0.001；95%CI 1.30 - 2.69），总生存期的合并HR为1.23（P = 0.005；95%CI 1.06 - 1.42）。
Ki-67高表达可能作为胃癌患者预后不良的预测生物标志物。根据Ki-67表达进行分层可能是选择治疗方案和综合管理时的一个考虑因素。
