Abstract
Background. We performed a systematic review and meta-analysis to study the association between serum endostatin levels and gastric cancer (GC) progression. Method. We searched the MEDLINE, Science Citation Index, Cochrane Library, PubMed, Embase, Current Contents Index, and several Chinese databases for published studies relevant to our study topic. Carefully selected studies were pooled and SMD and its corresponding 95% CI were calculated. Version 12.0 STATA software was used for statistical analysis. Results. Serum endostatin levels were analyzed in 12 case-control studies (736 GC patients and 350 controls). Significant differences in serum endostatin levels were observed between GC patients and the healthy controls (SMD = 1.418, 95% CI = 1.079~1.757, P < 0.001). Importantly, significantly lower levels of serum endostatin were found in I-II grade patients compared to those with III-IV grade tumors (P < 0.001). Further, higher serum endostatin levels were observed in the LN invasion-positive GC subjects in comparison with LN invasion-negative subjects (P < 0.001). Conclusion. Patients with GC exhibited elevated levels of serum endostatin than controls and its level showed a statistical correlation with the more aggressive type of GC, exhibiting invasion and LN metastasis. Thus, serum levels of endostatin being a useful prognostic biomarker for GC patients warrants further investigation.
Highlights
Gastric cancer (GC) is a malignant tumor arising from the stomach and is one of the most prevalent cancers in the world [1]
When serum endostatin levels were considered in relation to different stage of TNM, the results of the present study revealed significantly lower serum endostatin level in I-II grade compared with the III-IV tumor grade (SMD = −0.946, 95% confidence interval (95% CI) = −1.114∼ −0.778, P < 0.001)
The major results of our statistical analysis revealed that serum endostatin levels in gastric cancer (GC) patients were higher than those of healthy subjects, implying that serum levels of endostatin might reflect the pathogenesis of GC
Summary
Gastric cancer (GC) is a malignant tumor arising from the stomach and is one of the most prevalent cancers in the world [1]. More than one million people are newly diagnosed with GC each year, imposing a heavy burden on world health services [4]. Both genetic and epigenetic risk factors contribute to the carcinogenesis and progression of GC [5, 6]. Treatment approaches for GC vary widely depending on the tumor stage and characteristics at diagnosis, but treatment generally includes drugs and radical gastric excision [8]. We performed a systematic review and meta-analysis to study the association between serum endostatin levels and gastric cancer (GC) progression. Significant differences in serum endostatin levels were observed between GC patients and the healthy controls (SMD = 1.418, 95% CI = 1.079∼1.757, P < 0.001). Serum levels of endostatin being a useful prognostic biomarker for GC patients warrants further investigation
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