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Meta-Analysis: Prognostic Value of Survivin in Patients with Hepatocellular Carcinoma

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Listed:
  • Jin Long Liu
  • Xue Jun Zhang
  • Zhao Zhang
  • An Hong Zhang
  • Wei Wang
  • Jia Hong Dong

Abstract

Background: The expression of survivin is a promising prognostic indicator for some carcinomas. However, evidence for the prognostic value of survivin with respect to survival in hepatocellular carcinoma remains controversial. Aim: To conduct a systematic review of studies evaluating survivin expression in hepatocellular carcinoma as a prognostic indicator. Methods: The relevant literature was searched using PubMed, EMBASE, and Chinese biomedicine databases, and two meta-analyses were performed. One studied the association between survivin expression and the overall survival of patients with hepatocellular carcinoma, whereas the other studied the association between survivin expression and disease-free survival. Studies were pooled, and summary hazard ratios (HRs) were calculated. Subgroup analyses were also conducted. Results: Fourteen eligible studies with a total of 890 patients were included in this study. Two meta-analyses were performed according to the different outcomes by which prognosis was valued. The combined HR of the overall survival studies was 2.33 (95% CI: 1.65–3.31). The combined HR of disease-free survival studies was 2.13 (95% CI: 1.65–2.75). These data appeared to be significant when stratified by detection method, the language of publication, and HR estimate. The heterogeneities were highly significant (I2>50%) when subgroup analyses of overall survival rate were conducted, whereas little heterogeneity was found when subgroup analyses of disease-free survival rate were carried out. The positive expression of survivin in the cytoplasm was significantly correlated with poor prognosis in HCC (HR>1). Conclusions: This study showed that survivin expression was correlated with poor prognosis in patients with hepatocellular carcinoma, regardless whether they were assessed by overall survival or disease-free survival.

Suggested Citation

  • Jin Long Liu & Xue Jun Zhang & Zhao Zhang & An Hong Zhang & Wei Wang & Jia Hong Dong, 2013. "Meta-Analysis: Prognostic Value of Survivin in Patients with Hepatocellular Carcinoma," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-10, December.
    • Handle: RePEc:plo:pone00:0083350
    DOI: 10.1371/journal.pone.0083350
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    References listed on IDEAS

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    1. Chunguang Li & Zhigang Li & Maoling Zhu & Tiejun Zhao & Ling Chen & Weidan Ji & Hezhong Chen & Changqing Su, 2012. "Clinicopathological and Prognostic Significance of Survivin Over-Expression in Patients with Esophageal Squamous Cell Carcinoma: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-7, September.
    2. Fengzhi Li & Grazia Ambrosini & Emily Y. Chu & Janet Plescia & Simona Tognin & Pier Carlo Marchisio & Dario C. Altieri, 1998. "Control of apoptosis and mitotic spindle checkpoint by survivin," Nature, Nature, vol. 396(6711), pages 580-584, December.
    3. Jin Long Liu & Wei Gao & Qing Min Kang & Xue Jun Zhang & Shu Guang Yang, 2013. "Prognostic Value of Survivin in Patients with Gastric Cancer: A Systematic Review with Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-1, August.
    4. Lou Qian Zhang & Jun Wang & Feng Jiang & Lin Xu & Fu Yin Liu & Rong Yin, 2012. "Prognostic Value of Survivin in Patients with Non-Small Cell Lung Carcinoma: A Systematic Review with Meta-Analysis," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-9, March.
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