目的:Ki-67表达与食管鳞状细胞癌(ESCC)患者预后的关系已被广泛研究。然而,他们的发现是不一致的。因此,本Meta分析旨在确定Ki-67在预测ESCC预后方面的精确价值.
方法:当前的荟萃分析是按照系统评价和荟萃分析的首选报告项目指南进行的。
方法:PubMed的电子数据库,Embase,对WebofScience和Cochrane图书馆进行了系统搜索,直到2023年9月26日。
方法:计算合并的HR和相应的95%CI,以评估Ki-67在预测ESCC的总生存期(OS)和无病生存期(DFS)中的作用。使用Cochrane的Q检验和I2统计量评估研究之间的异质性。具体来说,根据Q统计检验的p<0.10或I2>50%确定了显着的异质性,因此应使用随机效应模型;否则,应该使用固定效应模型。结合ORs及其相应的95%CIs评价Ki-67与ESCC临床病理特征之间的关系。
结果:本荟萃分析纳入了11篇文献,共1124例患者。根据我们的分析,在ESCC中,Ki-67表达的增加与不良OS(HR1.62,95%CI1.15至2.28,p=0.006)和DFS(HR1.72,95%CI1.22至2.43,p=0.002)显着相关。此外,亚组分析显示,当使用>30%的Ki-67阈值时,Ki-67上调可显著预测OS和DFS.尽管如此,Ki-67与性别无关,T级,N级,TNM阶段,肿瘤分化或肿瘤位置。
结论:在本荟萃分析中,高Ki-67表达显著预测ESCC患者的OS和DFS,特别是当Ki-67>30%作为阈值时。这些结果表明,Ki-67可以作为ESCC的有效和可靠的预后指标。
OBJECTIVE: The relationship between Ki-67 expression and the prognosis of patients with oesophageal squamous cell carcinoma (ESCC) has been extensively studied. However, their findings were inconsistent. Consequently, the present meta-analysis was performed to identify the precise value of Ki-67 in predicting the prognosis of ESCC.
METHODS: The current meta-analysis was carried out in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
METHODS: Electronic databases of PubMed, Embase, Web of Science and Cochrane Library were systematically searched until 26 September 2023.
METHODS: Pooled HRs and corresponding 95% CIs were calculated to estimate the role of Ki-67 in predicting overall survival (OS) and disease-free survival (DFS) in ESCC. Between-study heterogeneity was evaluated using Cochrane\'s Q test and I2 statistics. Specifically, significant heterogeneities were identified based on p<0.10 on the Q statistic test or I2>50% so the random-effects model should be used; otherwise, the fixed-effects model should be used. The relationship between Ki-67 and clinicopathological characteristics of ESCC was evaluated by combining ORs with their corresponding 95% CIs.
RESULTS: 11 articles with 1124 patients were included in the present meta-analysis. Based on our analysis, increased Ki-67 expression was markedly associated with poor OS (HR 1.62, 95% CI 1.15 to 2.28, p=0.006) and DFS (HR 1.72, 95% CI 1.22 to 2.43, p=0.002) in ESCC. Moreover, subgroup analysis revealed that Ki-67 upregulation significantly predicted OS and DFS when a Ki-67 threshold of >30% was used. Nonetheless, Ki-67 was not significantly associated with sex, T stage, N stage, TNM stage, tumour differentiation or tumour location.
CONCLUSIONS: In the present meta-analysis, high Ki-67 expression significantly predicted OS and DFS in patients with ESCC, especially when Ki-67>30% was used as the threshold. These results suggest that Ki-67 could serve as an effective and reliable prognostic indicator for ESCC.