Ki-67 expression and patients survival in lung cancer: systematic review of the literature with meta-analysis.
Fiche publication
Date publication
décembre 2004
Journal
British journal of cancer
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MASCAUX Céline
Tous les auteurs :
Martin B, Paesmans M, Mascaux C, Berghmans T, Lothaire P, Meert AP, Lafitte JJ, Sculier JP
Lien Pubmed
Résumé
Among new biological markers that could become useful prognostic factors for lung carcinoma, Ki-67 is a nuclear protein involved in cell proliferation regulation. Some studies have suggested an association between Ki-67 and poor survival in lung cancer patients. In order to clarify this point, we have performed a systematic review of the literature, using the methodology already described by our Group, the European Lung Cancer Working Party. In total, 37 studies, including 3983 patients, were found to be eligible. In total, 49% of the patients were considered as having a tumour positive for the expression of Ki-67 according to the authors cutoff. In all, 29 of the studies dealt with non-small-cell lung carcinoma (NSCLC), one with small-cell carcinoma (SCLC), two with carcinoid tumours and five with any histology. In terms of survival results, Ki-67 was a bad prognosis factor for survival in 15 studies while it was not in 22. As there was no statistical difference in quality scores between the significant and nonsignificant studies evaluable for the meta-analysis, we were allowed to aggregate the survival results. The combined hazard ratio for NSCLC, calculated using a random-effects model was 1.56 (95% CI: 1.30-1.87), showing a worse survival when Ki-67 expression is increased. In conclusion, our meta-analysis shows that the expression of Ki-67 is a factor of poor prognosis for survival in NSCLC.
Mots clés
Biomarkers, Tumor, analysis, Humans, Ki-67 Antigen, biosynthesis, Lung Neoplasms, mortality, Prognosis, Survival Analysis
Référence
Br. J. Cancer. 2004 Dec 13;91(12):2018-25