Ki-67/MIB-1 as a prognostic factor in cervical cancer: a systematic review with meta-analysis

Background: In cervical cancer patients has been reported that there in a significant Ki-67/MIB-1 expression is correlated with survival in cervical cancer patients. However, the prognostic value of Ki-67/MIB-1 in cervical cancer is still not well understood.Method: In a meta-analysis the prognostic value of Ki-67/MIB-1 on overall survival (OS) and disease-free survival (DFS) in cervical cancer was investigated. The databases of PubMed, ISI Web of Science, Cochrane Central Register of Controlled Trials, EMBASE, Science Direct and Wiley Online Library were used to identify appropriate literatures.Results:In order to explore the relationship between Ki-67/MIB-1 and cervical cancer, we have included 13 studies covering 894 patients in the current meta-analysis. The effect of Ki-67/MIB-1 on OS for pooled random effects HR estimate was 1.63(95% CI 1.09-2.45; P> 0.05)Subgroup analysis by ethnicity suggested that high expression of Ki-67/MIB-1 had no association with Africans (HR=1.53, 95%CI 0.34-6.86) and Europeans(HR=1.29, 95%CI 0.74-2.23), but statistical difference was observed among in Asians(1.53, 95%CI 1.04-3.23) Furthermore, subgroup analysis of diverse treatments revealed no difference in surgery (HR=1.97, 95%CI 0.78-4.99) and radiation therapy (RT) (HR=1.56, 95%CI 0.93-2.63)The pooled HR for DFS was 1. 26(95%CI 0.58-2.73; P> 0.05) and the subgroup analysis indicated Ki-67/MIB1 was associated with DFS (HR=3.67, 95%CI 2.65-5.09) in Asians. In the treatment subgroup analysis, no direct value was found among surgery (HR=1.13, 95%CI 0.71-2.24) and RT (HR=1.26, 95%CI 0.71-2.24). Conclusions: According to this meta-analysis, Ki-67/MIB-1 had a prognostic value for OS in patients suffering cervical cancer. For better evaluation the prognostic role of Ki-67/MIB-1 on DFS, studies with larger size of patients are needed to validate present findings in the future.

کلیدواژه ها:

cervical cancer ، Ki-67/MIB-1 ، prognosis ، meta-analysis