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Meta-Analysis
. 2021 Mar 1;21(1):210.
doi: 10.1186/s12885-021-07880-y.

The relationship between the expression of Ki-67 and the prognosis of osteosarcoma

Ming Zeng  1 , Jian Zhou  1 , Lifang Wen  2 , Yanshan Zhu  2 , Yingquan Luo  3 , Wanchun Wang  4
Affiliations
Meta-Analysis

The relationship between the expression of Ki-67 and the prognosis of osteosarcoma

Ming Zeng et al. BMC Cancer. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Clinicopathological features; Ki-67; Meta-analysis; Osteosarcoma; Prognosis; TCGA dataset.

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Conflict of interest statement

The authors declare that they do not have any competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of paper selection
Fig. 2
Fig. 2
Forest plot of the association between Ki-67 expression and OS. a: classification, b: enneking stage, c: metastasis, d: overall survival
Fig. 3
Fig. 3
Sensitivity analysis indicating the association between Ki-67 expression and OS. a: classification, b: enneking stage, c: metastasis, d: overall survival
Fig. 4
Fig. 4
Analysis for the expression and prognosis of Ki-67 in cancers. a: differential expression of Ki-67 in various cancers, b: differential expression of Ki-67 in sarcoma, c-f: association between Ki-67 and over survival (c and e), disease free survival (d) and recurrence free survival (f) in sarcoma
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