Prognostic and clinicopathological value of Ki-67 expression in patients with nasopharyngeal carcinoma: a meta-analysis

Zhaohui Shi; Weihong Jiang; Xiaodong Chen; Min Xu; Xiaocheng Wang; Dingjun Zha

doi:10.1177/1758835920951346

Prognostic and clinicopathological value of Ki-67 expression in patients with nasopharyngeal carcinoma: a meta-analysis

Ther Adv Med Oncol. 2020 Sep 20:12:1758835920951346. doi: 10.1177/1758835920951346. eCollection 2020.

Authors

Zhaohui Shi¹, Weihong Jiang², Xiaodong Chen¹, Min Xu¹, Xiaocheng Wang¹, Dingjun Zha³

Affiliations

¹ Department of Otorhinolaryngology Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China.
² Department of Otolaryngology-Skull Base Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
³ Department of Otorhinolaryngology Head and Neck Surgery, Xijing Hospital, Air Force Medical University, ChangLe West Road 127, Xi'an, Shaanxi 710032, China.

Abstract

Background: This meta-analysis aimed to identify the prognostic role of Ki-67 in patients with nasopharyngeal carcinoma (NPC).

Methods: Relevant studies were retrieved in the PubMed, Embase, Web of Science, and Cochrane Library databases up to November 2019. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to estimate the association between Ki-67 expression and survival outcomes. Combined odds ratios (ORs) and 95% CIs were measured as effect size on the association between Ki-67 expression and clinical factors.

Results: A total of eight studies involving 936 patients with NPC were included in this meta-analysis. The pooled HR indicated that Ki-67 expression was significantly associated with poor overall survival (HR = 2.86, 95% CI = 1.91-4.27, p < 0.001), progression-free survival (HR = 1.78, 95% CI = 1.15-2.74, p = 0.009), and distant metastasis-free survival (HR = 1.65, 95% CI = 1.15-2.36, p = 0.007). However, there was no significant correlation between Ki-67 expression and local recurrence-free survival (HR = 1.07, 95% CI = 0.54-2.14, p = 0.843). Ki-67 overexpression was associated with higher T stage (OR = 1.48, 95% CI = 1.00-2.20, p = 0.052), and the relationship between Ki-67 expression and advanced stage was nearly significant (OR = 2.25, 95% CI = 0.99-5.14, p = 0.054). However, high Ki-67 expression was not significantly correlated with sex, age, N stage, or histological type.

Conclusion: This meta-analysis demonstrated that Ki-67 overexpression was a significant marker for poor prognosis in patients with NPC. Ki-67 should be recommended as a useful index for prognostication in patients with NPC.

Keywords: Ki-67; management; meta-analysis; nasopharyngeal carcinoma; prognosis.