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. 2017 Sep 1:10:4321-4328.
doi: 10.2147/OTT.S143089. eCollection 2017.

Clinicopathological and prognostic significance of Ki-67 immunohistochemical expression in gastric cancer: a systematic review and meta-analysis

Gang Liu #  1 , Disheng Xiong #  1   2 , Junjie Zeng  1 , Borong Chen  1 , Zhengjie Huang  1   2
Affiliations

Clinicopathological and prognostic significance of Ki-67 immunohistochemical expression in gastric cancer: a systematic review and meta-analysis

Gang Liu et al. Onco Targets Ther. .

Abstract

The prognostic significance of Ki-67 in patients with gastric cancer (GC) remains controversial. The aim of our meta-analysis is to evaluate its association with clinicopathological characteristics and prognostic value in patients with GC. PubMed, EMBASE, and Web of Science were systematically searched up to May 2017. Twenty-two studies including 3,825 patients with GC were analyzed. The meta-analysis indicated that the incidence difference of Ki-67 expression in GC patients was significant when comparing the older group to younger group (odds ratio [OR] =1.44, 95% confidence interval [CI] 1.19, 1.75), lymph node positive group to negative group (OR =1.49, 95% CI 1.20, 1.84), the large size tumor group to the small size tumor group (OR =1.27, 95% CI 1.24, 1.68) and the TNM stage III+IV group to TNM stage I+II group (OR =2.28, 95% CI 1.66, 3.12). However, no statistical differences existed in gender. The detection of Ki-67 significantly correlated with the overall survival of patients (hazard ratio =1.51, 95% CI 1.31, 1.72). Our study suggested that Ki-67 overexpression was associated with poor prognosis in GC patients. Ki-67 positive rates may be associated with age, lymph node metastasis, tumor size, and TNM staging system in GC patients.

Keywords: Ki-67; gastric cancer; meta-analysis; prognostic.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of the meta-analysis process.
Figure 2
Figure 2
HRs and 95% CIs in studies assessing the relationship between Ki-67 expression and OS. Abbreviations: CI, confidence interval; HR, hazard ratio; IV, inverse variance; OS, overall survival; SE, standard error.
Figure 3
Figure 3
Forest plot of studies evaluating the association between Ki-67 and clinical parameters (older vs younger age) in gastric cancer with fixed-effects model. Abbreviations: CI, confidence interval; M–H, Mantel–Haenszel.
Figure 4
Figure 4
Forest plot of studies evaluating the association between Ki-67 and clinical parameters (male vs female gender) in gastric cancer with fixed-effects model. Abbreviations: CI, confidence interval; M–H, Mantel–Haenszel.
Figure 5
Figure 5
Forest plot of studies evaluating the association between Ki-67 and clinical parameters (N+ vs N− lymph node metastasis) in gastric cancer with fixed-effects model. Abbreviations: CI, confidence interval; LNM, lymph node metastasis; M–H, Mantel–Haenszel.
Figure 6
Figure 6
Forest plot of studies evaluating the association between Ki-67 and clinical parameters (large vs small tumor size) in gastric cancer with fixed-effects model. Abbreviations: CI, confidence interval; M–H, Mantel–Haenszel.
Figure 7
Figure 7
Forest plot of studies evaluating the association between Ki-67 and clinical parameters (III+IV vs I+II TNM stage) in gastric cancer with fixed-effects model. Abbreviations: CI, confidence interval; M–H, Mantel–Haenszel.
Figure 8
Figure 8
Forest plot of studies evaluating the association between Ki-67 and clinical parameters (low vs well/moderate differentiation) in gastric cancer with random-effects model. Abbreviations: CI, confidence interval; M–H, Mantel–Haenszel.
Figure 9
Figure 9
Funnel plot and Begg’s and Egger’s tests for evaluation of potential publication bias. Abbreviations: HR, hazard ratio; SE, standard error.
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