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Meta-Analysis
. 2018 Aug 13;19(1):150.
doi: 10.1186/s12931-018-0843-7.

Augmented expression of Ki-67 is correlated with clinicopathological characteristics and prognosis for lung cancer patients: an up-dated systematic review and meta-analysis with 108 studies and 14,732 patients

Dan-Ming Wei  1 , Wen-Jie Chen  1 , Rong-Mei Meng  1 , Na Zhao  1 , Xiang-Yu Zhang  1 , Dan-Yu Liao  1 , Gang Chen  2
Affiliations
Meta-Analysis

Augmented expression of Ki-67 is correlated with clinicopathological characteristics and prognosis for lung cancer patients: an up-dated systematic review and meta-analysis with 108 studies and 14,732 patients

Dan-Ming Wei et al. Respir Res. .

Abstract

Background: Lung cancer ranks as the leading cause of cancer-related deaths worldwide and we performed this meta-analysis to investigate eligible studies and determine the prognostic effect of Ki-67.

Methods: In total, 108 studies in 95 articles with 14,732 patients were found to be eligible, of which 96 studies reported on overall survival (OS) and 19 studies reported on disease-free survival (DFS) with relation to Ki-67 expression in lung cancer patients.

Results: The pooled hazard ratio (HR) indicated that a high Ki-67 level could be a valuable prognostic factor for lung cancer (HR = 1.122 for OS, P < 0.001 and HR = 1.894 for DFS, P < 0.001). Subsequently, the results revealed that a high Ki-67 level was significantly associated with clinical parameters of lung cancer including age (odd ratio, OR = 1.246 for older patients, P = 0.018), gender (OR = 1.874 for males, P < 0.001) and smoking status (OR = 3.087 for smokers, P < 0.001). Additionally, significant positive correlations were found between Ki-67 overexpression and poorer differentiation (OR = 1.993, P = 0.003), larger tumor size (OR = 1.436, P = 0.003), and higher pathologic stages (OR = 1.867 for III-IV, P < 0.001). Furthermore, high expression of Ki-67 was found to be a valuable predictive factor for lymph node metastasis positive (OR = 1.653, P < 0.001) and advanced TNM stages (OR = 1.497 for stage III-IV, P = 0.024). Finally, no publication bias was detected in any of the analyses.

Conclusions: This study highlights that the high expression of Ki-67 is clinically relevant in terms of the prognostic and clinicopathological characteristics for lung cancer. Nevertheless, more prospective well-designed studies are warranted to validate these findings.

Keywords: Clinicopathological characteristics; Ki-67; Lung cancer; Meta-analysis; Prognosis.

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Conflict of interest statement

Not applicable.

Not applicable.

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Flow chart of study selection process
Fig. 2
Fig. 2
Hazard ratios and 95% CIs of studies included in meta-analysis of OS
Fig. 3
Fig. 3
Hazard ratios and 95% CIs of studies included in meta-analysis of OS
Fig. 4
Fig. 4
Hazard ratios and 95% CIs of studies included in meta-analysis of OS
Fig. 5
Fig. 5
Hazard ratios and 95% CIs of studies included in meta-analysis of DFS
Fig. 6
Fig. 6
Funnel plots for publication bias of OS and DFS meta-analysis
See this image and copyright information in PMC

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