Abstract
BackgroundPublished studies present conflicting data regarding the impact of Thrombospondin-1 (TSP-1) expression on prognosis of various cancers. We performed this meta-analysis to illustrate the preliminary predictive value of TSP-1.MethodsTwenty-four studies with a total of 2379 patients were included. A comprehensive literature search was performed by using PubMed, Cochrane Library, Web of Science, Embase, and hand searches were also conducted of relevant bibliographies. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for patient survival and disease recurrence were initially identified to explore relationships between TSP-1 expression and patient prognosis.ResultsA total of 24 eligible studies were included in this meta-analysis. Our results showed that high level of TSP-1 was correlated significantly with poor overall survival (OS) (HR = 1.40, 95% CI: 1.17 ~ 1.68; P<0.001). However, high TSP-1 expression predicted no significant impact on progression-free survival (PFS)/ metastasis-free survival (MFS) (HR = 1.35, 95%CI: 0.87–2.10; P = 0.176) and disease-free survival (DFS)/ recurrence-free survival (RFS) (HR = 1.40, 95%CI: 0.77–2.53; P = 0.271). In addition, we performed subgroup analyses which showed that high TSP-1 expression predicted poor prognosis in breast cancer and gynecological cancer. Additionally, the relatively small number of studies on PFS/MFS and DFS/RFS is a limitation. The data extracted through Kaplan-Meier curves may not be accurate. Moreover, only English articles were included in this article, which may lead to deviations in the results.ConclusionsOur findings indicated high TSP-1 expression may act as a promising biomarker of poor prognosis in cancers, especially in breast cancer and gynecological cancer.
Highlights
Published studies present conflicting data regarding the impact of Thrombospondin-1 (TSP-1) expression on prognosis of various cancers
Inclusion criteria and exclusion criteria We considered articles were considered qualified when they met the following criteria: (1) patients diagnosed with cancers by using pathological methods (2) studies focusing on the relationship between TSP-1 expression and prognosis, (3) survival outcomes with 95% confidence intervals (CIs) and hazard ratios (HRs) that could be extracted directly or indirectly
Based on screening of titles and abstracts, 54 studies were selected for further investigation according to following criteria: repetitive articles, not a human study, not original articles, no clinical parameters, unrelated to TSP-1, unrelated to malignant neoplasms and unrelated to prognosis or survival
Summary
Published studies present conflicting data regarding the impact of Thrombospondin-1 (TSP-1) expression on prognosis of various cancers. We performed this meta-analysis to illustrate the preliminary predictive value of TSP-1. Thrombospondin gene family plays a role in extensive physiological and pathological processes, including development, angiogenesis, inflammation and neoplasia [3]. This TSP family interact with a variety of membrane proteins on the cell surface, such as proteoglycans, integrins, CD36 and CD47 [4, 5]. TSP-1 is composed of three identical peptide chains, each showing a spherical amino at one end and a spherical carboxyl at the other end, connected by a
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