Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
BMC Med Genet. 2020 Jun 29;21(1):139. doi: 10.1186/s12881-020-01073-3.
Published studies present conflicting data regarding the impact of Thrombospondin-1 (TSP-1) expression on prognosis of various cancers. We performed this meta-analysis to illustrate the preliminary predictive value of TSP-1.
Twenty-four studies with a total of 2379 patients were included. A comprehensive literature search was performed by using PubMed, Cochrane Library, Web of Science, Embase, and hand searches were also conducted of relevant bibliographies. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for patient survival and disease recurrence were initially identified to explore relationships between TSP-1 expression and patient prognosis.
A total of 24 eligible studies were included in this meta-analysis. Our results showed that high level of TSP-1 was correlated significantly with poor overall survival (OS) (HR = 1.40, 95% CI: 1.17 ~ 1.68; P<0.001). However, high TSP-1 expression predicted no significant impact on progression-free survival (PFS)/ metastasis-free survival (MFS) (HR = 1.35, 95%CI: 0.87-2.10; P = 0.176) and disease-free survival (DFS)/ recurrence-free survival (RFS) (HR = 1.40, 95%CI: 0.77-2.53; P = 0.271). In addition, we performed subgroup analyses which showed that high TSP-1 expression predicted poor prognosis in breast cancer and gynecological cancer. Additionally, the relatively small number of studies on PFS/MFS and DFS/RFS is a limitation. The data extracted through Kaplan-Meier curves may not be accurate. Moreover, only English articles were included in this article, which may lead to deviations in the results.
Our findings indicated high TSP-1 expression may act as a promising biomarker of poor prognosis in cancers, especially in breast cancer and gynecological cancer.
已发表的研究报告呈现出相互矛盾的数据，说明血小板反应蛋白-1（TSP-1）的表达对各种癌症预后的影响。我们进行了此项荟萃分析，旨在说明 TSP-1 的初步预测价值。
共纳入了 24 项研究，总计 2379 例患者。通过使用 PubMed、Cochrane 图书馆、Web of Science、Embase 进行全面的文献检索，并对相关文献进行手工检索。最初确定 TSP-1 表达与患者生存和疾病复发之间的关系，通过合并风险比（HR）和 95%置信区间（CI）来评估患者生存情况。
本荟萃分析共纳入了 24 项符合条件的研究。结果表明，TSP-1 高水平与总生存期（OS）不良显著相关（HR=1.40，95%CI：1.17~1.68；P<0.001）。然而，TSP-1 高表达对无进展生存期（PFS）/无转移生存期（MFS）（HR=1.35，95%CI：0.87-2.10；P=0.176）和无病生存期（DFS）/无复发生存期（RFS）（HR=1.40，95%CI：0.77-2.53；P=0.271）无显著影响。此外，我们进行了亚组分析，结果表明 TSP-1 高表达预示着乳腺癌和妇科癌症的预后不良。此外，关于 PFS/MFS 和 DFS/RFS 的研究数量相对较少，这是一个局限性。通过 Kaplan-Meier 曲线提取的数据可能不够准确。此外，本文只纳入了英文文章，这可能导致结果存在偏差。
我们的研究结果表明，TSP-1 高表达可能是癌症患者预后不良的一个有前途的生物标志物，尤其是在乳腺癌和妇科癌症中。
