Ki-67 Labeling Index can be used as a Prognostic Marker in Gastrointestinal Stromal Tumor: A Systematic Review and Meta-Analysis. Issue 2 (April 2016)

• Record Type: Journal Article
• Authors: Pyo, Jung-Soo; Kang, Guhyun; Sohn, Jin Hee
• Is Part Of: International journal of biological markers. Volume 31:Issue 2(2016)
• Page Start: 204
• Page End: 210
• Publication Date: 2016-04
• Subjects: Gastrointestinal stromal tumor -- Ki-67 -- Meta-analysis -- Prognosis -- Risk stratification; Cell receptors -- Periodicals; Histochemistry -- Periodicals; Tumor markers -- Periodicals; Tumor antigens -- Periodicals; 616.99407582
• DOI: 10.5301/jbm.5000183
• Languages: English
• ISSNs: 0393-6155

Abstract

Purpose: The aim of this study was to investigate the prognostic relevance of the Ki-67 labeling index (LI) in gastrointestinal stromal tumor (GIST) through a systematic review, meta-analysis and diagnostic test accuracy review. Method: The study included 1, 967 GIST cases from 24 eligible studies. We investigated the correlation between high Ki-67 LI and survival and the proper criteria for high Ki-67 LI. In addition, a diagnostic test accuracy review was conducted to evaluate the predictive role of high Ki-67 LI for higher risk of tumor recurrence. Results: A high Ki-67 LI was significantly correlated with worse disease-free survival (DFS) (hazard ratio [HR] 3.658, 95% confidence interval [CI] 2.687-4.979, p<0.001) and overall survival (OS) (HR 3.730, 95% CI 2.819-4.936, p<0.001). With regard to DFS and OS, the subgroup with a cutoff value of >4% for high Ki-67 LI had a higher HR than the subgroup with a ≤4% cutoff. In the diagnostic test accuracy review, a high Ki-67 LI was significantly correlated with higher risk of tumor recurrence (pooled sensitivity = 0.44, pooled specificity = 0.87, area under the curve on the summary receiver operating characteristic curve = 0.656). Conclusions: Our results showed that a high Ki-67 LI was significantly correlated with worse prognosis and higher risk of tumor recurrence in GIST. Further prospective studies of the prognostic role of Ki-67 LI are necessary prior to application in clinical practice.