| AIM:Previous studies on Hepatocellular carcinoma in the liver tissue of the tumor markers and the relationship between the clinical features of liver cancer prognosis of remains controersial.This subject aim to investigate the prognostic and clinicopathological significance of glypican-3(GPC3)overexpression in HCC.METHODS:Publications were searched using Pub Med?EMBASE and the Cochrane Library up to 2017-2 by computer.Inclusion and exclusion criteria were established to screen eligible studies for meta-analysis.Using Rev Man 5.3 software to analyze data and Endnote X7 software to summary literature.The hazard ratios(HRs)of the eligible studies were pooled to evaluate the impact of GPC3 overexpression on overall survival(OS)and disease-free survival(DFS)in HCC patients.For articles in which the survival data were not directly published except in Kaplan-Meier curves,the software Engauge Digitizer version 4.1 was used to read the curves for data extraction.When the combined results of p values < 0.05 is defined as the study statistically significant,when the HR value > 1 and the 95% confidence interval does not include 1,defined as the high expression of GPC3 is associated with adverse outcomes in patients with primary liver cancer was statistically.When the OR value of the 95% confidence interval does not include 1,defined as the high expression of GPC3 is associated with tumor clinical pathological features exist statistical.RESULTS:A total of ten studies with 1258 patients were included in the meta-analysis,including 894 patients with high level of GPC3 and 364 patients with low level of GPC3.Our analysis results indicated that high GPC3 expression predicted poor overall survival(OS: HR =1.98,95% CI:1.57-2.49,P <0.00001),suggesting high levels of GPC3 is associated with poor prognosis.High levels of patients with GPC3 expression predicted poor disease-free survival(DFS: HR =1.95,95% CI:1.50-2.55,P <0.00001),increased the risk of death in patients with HCC.There was no statistical heterogeneity among the studies(I2 was 4%,22% respectively).It was showed that there was stasticaly difference betweenth high levels of GPC3 and tumor vascular invasion(OR =2.57,95%CI: 1.75-3.77,P<0.00001)?lower tumor differentiation(OR = 3.65,95%CI: 2.38-5.61,P < 0.00001)and advanced TNM staging(OR =2.78,95%CI: 1.93-3.99,P < 0.00001).There was no significant statistical difference between multiple tumors(OR =1.63,95%CI: 0.71-3.73,P=0.25)and tumor size(greater than 5 cm versus less than 5 cm)(OR = 1.31,95%CI:0.91-1.87,P =0.15)?liver cirrhosis(OR = 1.37,95%CI: 0.98-1.91,P =0.06).Conclusion:1?The high expression of GPC3 was significantly correlated with the overall survival and disease-free survival of patients with primary liver cancer.With the increase of the expression level of GPC3 in HCC,the overall survival and disease-free survival of patients with liver cancer were shortened.These results suggest that the high expression of GPC3 is associated with the poor prognosis of HCC patients.2?The high expression of GPC3 is also associated with some clinicopathological features of patients with primary liver cancer,such as tumor vessel invasion,medium to low grade tumor differentiation,and advanced TNM stage.The results showed that with the increase of the expression level of GPC3,the malignant behavior of tumor increased. |
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