Department of Orthopedics, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China.
Department of Dermatology, Hunan Key Laboratory of Medical Epigenomes, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
BMC Cancer. 2021 Mar 1;21(1):210. doi: 10.1186/s12885-021-07880-y.
A number of studies have linked positive Ki-67 expression with the prognosis of osteosarcoma (OS) patients. However, the results have been conflicting. To address this controversy, we conducted an analysis using a meta-analysis and a TCGA dataset to estimate the value of Ki-67 expression in the prognosis of OS.
A comprehensive search for relevant papers was conducted using NCBI PubMed, Embase, Springer, ISI Web of Knowledge, the Cochrane Library, and CNKI regardless of the publication year. The associations between Ki-67 expression and the clinical features and main prognostic outcomes of OS were measured. The TCGA dataset was also analyzed. The pooled odds ratio (OR) and its 95% confidential intervals (CIs) were utilized for statistical analysis.
Overall, a total of 12 studies with 500 cases were included, and the results indicated that the expression of Ki-67 was significantly associated with Enneking stage (OR = 6.88, 95% CI: 2.92-16.22, p < 0.05), distant metastasis (OR = 3.04, 95% CI: 1.51-6.12, p < 0.05) and overall survival (OR = 8.82, 95% CI: 4.68-16.65, p < 0.05) in OS patients. Additionally, we observed no significant heterogeneity among all retrieved studies. Associations between Ki-67 expression and overall survival and disease-free survival of sarcoma were confirmed using the TCGA and Kaplan-Meier plotter datasets.
The present study strongly suggests that positive Ki-67 expression was associated with Enneking stage, distant metastasis, and overall survival of OS, and it may be used as a potential biomarker to predict prognosis and guide clinical therapy for OS.
多项研究表明，Ki-67 阳性表达与骨肉瘤（OS）患者的预后相关。然而，结果存在争议。为了解决这一争议，我们进行了一项荟萃分析和 TCGA 数据集的分析，以评估 Ki-67 表达在 OS 预后中的价值。
我们通过 NCBI PubMed、Embase、Springer、ISI Web of Knowledge、Cochrane 图书馆和中国知网，无论发表年份如何，全面检索了相关文献。测量了 Ki-67 表达与 OS 临床特征和主要预后结局之间的关系。还分析了 TCGA 数据集。使用合并的优势比（OR）及其 95%置信区间（CI）进行统计分析。
总体而言，共纳入了 12 项研究，共计 500 例患者，结果表明 Ki-67 表达与 Enneking 分期（OR=6.88，95%CI：2.92-16.22，p<0.05）、远处转移（OR=3.04，95%CI：1.51-6.12，p<0.05）和总生存（OR=8.82，95%CI：4.68-16.65，p<0.05）显著相关。此外，我们观察到所有检索到的研究之间没有显著的异质性。使用 TCGA 和 Kaplan-Meier 绘图器数据集验证了 Ki-67 表达与肉瘤总生存和无病生存之间的关系。
本研究强烈表明，Ki-67 阳性表达与 OS 的 Enneking 分期、远处转移和总生存相关，它可能被用作预测预后和指导 OS 临床治疗的潜在生物标志物。
