A Comprehensive Evaluation of the Association between Polymorphisms in XRCC1, ERCC2, and XRCC3 and Prognosis in Hepatocellular Carcinoma: A Meta-Analysis

Purpose. Associations between XRCC1, XRCC3, and ERCC2 gene polymorphism and prognosis have been investigated in several cancers. The aim of this meta-analysis was to assess the prognostic value of XRCC1, XRCC3, and ERCC2 gene polymorphism in hepatocellular carcinoma (HCC). Methods. A systematic literature search was performed to identify relevant studies in PubMed, Embase, and the Cochrane library up to December 2018. The prognostic values of XRCC1, XRCC3, and ERCC2 polymorphisms in HCC were estimated using crude HRs with 95% CIs. Results. Ten studies involving 2687 patients were included in the quantitative analysis. There were no statistically significant associations between XRCC1 rs1799782 C>T, XRCC1 rs25487 G>A, and ERCC2 rs1799793 G>A polymorphisms and overall survival (OS). OS was significantly longer for the ERCC2 rs13181 CC genotype than for AA (CC vs. AA: HR = 0.33, 95% CI = 0.15–0.72). A significantly lower OS was observed for patients with the CT genotype compared with the CC genotype at XRCC3 rs861539 (CT vs. CC: HR = 1.64, 95% CI = 1.11–2.42). Conclusion. The ERCC2 rs13181 A>C polymorphism and XRCC3 rs861539 C>T polymorphism may be predictive markers for prognosis in patients with HCC. Well-designed studies with larger sample sizes are needed to verify our findings.

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Association of genetic variants in enamel-formation genes with dental caries: A meta- and gene-cluster analysis

10.1101/2020.09.19.20198044 ◽

2020 ◽

Author(s):

Xueyan Li ◽

DI LIU ◽

Sun Yang ◽

Jingyun Yang ◽

Youcheng Yu

Keyword(s):

Cluster Analysis ◽

Dental Caries ◽

Gene Cluster ◽

Genetic Variants ◽

Literature Search ◽

Genetic Variant ◽

Meta Analysis ◽

Cochrane Library ◽

Systematic Literature Search ◽

Enamel Formation

Previous studies have reported the association between multiple genetic variants in enamel formation-related genes and the risk of dental caries with inconsistent results. We performed a systematic literature search of the PubMed, Cochrane Library, HuGE and Google Scholar databases for studies published before March 21, 2020 and conducted meta-, gene-based and gene-cluster analysis on the association between genetic variants in enamel- formation-related genes and the risk of dental caries. Our systematic literature search identified 21 relevant publications including a total of 24 studies for analysis. The genetic variant rs17878486 in AMELX was significantly associated with dental caries risk (OR=1.40, 95% CI: 1.02-1.93, P=0.037). We found no significant association between the risk of dental caries with rs12640848 in ENAM (OR=1.15, 95% CI: 0.88-1.52, P=0.310), rs1784418 in MMP20 (OR=1.07, 95% CI: 0.76-1.49, P=0.702) and rs3796704 in ENAM (OR=1.06, 95% CI: 0.96-1.17, P=0.228). Gene-based analysis indicated that multiple genetic variants in AMELX showed joint association with the risk of dental caries (6 variants; P<10-5), so did genetic variants in MMP13 (3 variants; P=0.004), MMP2 (3 variants; P<10-5), MMP20 (2 variants; P<10-5) and MMP3 (2 variants; P<10-5). The gene-cluster analysis indicated a significant association between the genetic variants in this enamel-formation gene cluster and the risk of dental caries (P<10-5). The present meta-analysis revealed that genetic variant rs17878486 in AMELX were associated with dental caries, and multiple genetic variants in enamel-formation-related genes jointly contribute to the risk of dental caries, supporting the role of genetic variants in the enamel-formation genes in the etiology of dental caries.

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Prognostic Value of Lactate Dehydrogenase in Patients with Hepatocellular Carcinoma: A Meta-Analysis

BioMed Research International ◽

10.1155/2018/1723184 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Weihao Kong ◽

Xiaomin Zuo ◽

Hao Liang ◽

Jingxiong Hu ◽

Huabing Zhang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Sensitivity Analysis ◽

Lactate Dehydrogenase ◽

Publication Bias ◽

Subgroup Analysis ◽

Prognostic Value ◽

Meta Analysis ◽

Progression Free Survival ◽

Cochrane Library ◽

Free Survival

Background. Previous studies have shown the prognostic value of lactate dehydrogenase (LDH) in hepatocellular carcinoma (HCC), but the results are not persuasive. Therefore, the purpose of our study was to quantitatively explore the prognostic value of LDH in hepatocellular carcinoma.Methods. We searched the Web of Science, Embase, PubMed, and the Cochrane Library for literature published before October 2018 on the prognostic value of LDH in patients with hepatocellular carcinoma. The combined hazard ratios (HRs) and 95% confidence intervals (CIs) were utilized to assess the prognostic value of LDH in overall survival (OS), recurrence-free survival (RFS), and progression-free survival (PFS) of HCC. Subgroup analysis, sensitivity analysis, and metaregression were used to explore the source of heterogeneity. Funnel plots with Begg’s test and Egger’s test were used to detect potential publication biases. Furthermore, combined odds ratios (ORs) were utilized to assess the correlation between LDH and clinicopathological features.Results. A total of 10 nonrandomized controlled studies were included in this meta-analysis. The combined effects of LDH on HCC patients’ OS, RFS/DFS, and PFS were HR = 2.07, 95% CI: 1.63-2.62, P < 0.001; HR = 1.62, 95% CI: 1.37-1.90, P < 0.001; and HR = 1.96, 95% CI: 1.14-3.36, P = 0.014, respectively. Subgroup analysis and sensitivity analysis showed that the outcome was stable, and the results of the metaregression also identified statistical models as an important source of heterogeneity. Potential publication bias was detected in the OS studies, so the trim-and-fill method was used to explore publication bias, and the results showed stability. Furthermore, the combined OR suggests that LDH was significantly correlated with gender, Child-Pugh grade, alpha-fetoprotein, vascular invasion, and tumor size.Conclusions. Preoperative LDH elevation is significantly associated with poor prognosis in patients with HCC, which may be a promising factor in assessing the prognosis of patients with HCC.

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Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio as Prognostic Predictors for Hepatocellular Carcinoma Patients with Various Treatments: a Meta-Analysis and Systematic Review

Cellular Physiology and Biochemistry ◽

10.1159/000485396 ◽

2017 ◽

Vol 44 (3) ◽

pp. 967-981 ◽

Cited By ~ 59

Author(s):

Jun Zheng ◽

Jianye Cai ◽

Hui Li ◽

Kaining Zeng ◽

Liying He ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Systematic Review ◽

Meta Analysis ◽

Palliative Therapy ◽

Neutrophil To Lymphocyte Ratio ◽

Cochrane Library ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Poor Outcomes ◽

The Cochrane Library

Background/Aims: Systemic inflammatory response (SIR) is widely considered as a preoperative risk factor for hepatocellular carcinoma (HCC) outcomes. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), two of the prognostic indices, have been investigated in post-therapeutic recurrence and survival of HCC. Here, we quantify the prognostic value of these two biomarkers and evaluate their consistency in different HCC therapies. Methods: A systematic review of electronic database of the Web of Science, Embase, PubMed and the Cochrane Library was conducted to search for associations between the NLR and PLR in the blood and clinical outcomes of HCC. Overall survival (OS) and recurrence-free survival (RFS) were the primary outcomes, and hazard ratios (HRs) and 95% confidence intervals (95% CIs) were explored as effect measures. Subgroup analyses were performed to explore the heterogeneity of different therapies. Results: A total of 24 articles comprising 6318 patients were included in the meta-analysis. Overall, the pooled outcomes revealed that a high NLR before treatment predicted a poor OS (HR: 1.54, 95% CI: 1.34 to 1.76, p<0.001) and poor RFS (HR: 1.45, 95% CI: 1.16 to 1.82, p=0.001). Moreover, an increased PLR predicted a poor OS (HR: 1.63, 95% CI: 1.34 to 1.98, p<0.001) and earlier HCC recurrence (HR: 1.52, 95% CI: 1.21 to 1.91, p<0.001). In addition, both the NLR and PLR were identified as independent risk factors for predicting OS and RFS in HCC patients in a subgroup analysis of different treatment types, including curative or palliative therapy; however, these results were not found in the sorafenib subgroup due to limited clinical research. Conclusion: An increased NLR or PLR indicated poor outcomes for patients with HCC. The NLR and PLR may be considered as reliable and inexpensive biomarkers for making clinical decisions regarding HCC treatment.

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Prediction of mortality in adult patients with sepsis using six biomarkers: a systematic review and meta-analysis

Annals of Intensive Care ◽

10.1186/s13613-019-0600-1 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 10

Author(s):

Andreas Pregernig ◽

Mattia Müller ◽

Ulrike Held ◽

Beatrice Beck-Schimmer

Keyword(s):

Systematic Review ◽

Literature Search ◽

Meta Analysis ◽

Advanced Glycation Endproducts ◽

Adult Patients ◽

Cochrane Library ◽

Systematic Literature Search ◽

Prognostic Information ◽

Prediction Of Mortality ◽

Mean Differences

Abstract Background Angiopoietin-1 (Ang-1) and 2 (Ang-2), high mobility group box 1 (HMGB1), soluble receptor for advanced glycation endproducts (sRAGE), soluble triggering receptor expressed on myeloid cells 1 (sTREM1), and soluble urokinase-type plasminogen activator receptor (suPAR) have shown promising results for predicting all-cause mortality in critical care patients. The aim of our systematic review and meta-analysis was to assess the prognostic value of these biomarkers for mortality in adult patients with sepsis. Methods A systematic literature search of the MEDLINE, PubMed, EMBASE, and Cochrane Library databases, for articles in English published from 01.01.1990 onwards, was conducted. The systematic review focused exclusively on observational studies of adult patients with sepsis, any randomized trials were excluded. For the meta-analysis, only studies which provide biomarker concentrations within 24 h of admission in sepsis survivors and nonsurvivors were included. Results are presented as pooled mean differences (MD) between nonsurvivors and survivors with 95% confidence interval for each of the six biomarkers. Studies not included in the quantitative analysis were narratively summarized. The risk of bias was assessed in all included studies using the Quality in Prognosis Studies (QUIPS) tool. Results The systematic literature search retrieved 2285 articles. In total, we included 44 studies in the qualitative analysis, of which 28 were included in the meta-analysis. The pooled mean differences in biomarker concentration (nonsurvivors − survivors), measured at onset of sepsis, are listed as follows: (1) Ang-1: − 2.9 ng/ml (95% CI − 4.1 to − 1.7, p < 0.01); (2) Ang-2: 4.9 ng/ml (95% CI 2.6 to 7.1, p < 0.01); (3) HMGB1: 1.2 ng/ml (95% CI 0.0 to 2.4, p = 0.05); (4) sRAGE: 1003 pg/ml (95% CI 628 to 1377, p < 0.01); (5) sTREM-1: 87 pg/ml (95% CI 2 to 171, p = 0.04); (6) suPAR: 5.2 ng/ml (95% CI 4.5 to 6.0, p < 0.01). Conclusions Ang-1, Ang-2, and suPAR provide beneficial prognostic information about mortality in adult patients with sepsis. The further development of standardized assays and the assessment of their performance when included in panels with other biomarkers may be recommended. Trial registration This study was recorded on PROSPERO, prospective register of systematic reviews, under the registration ID: CRD42018081226

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The Prognostic Value of Early Repolarization Pattern for the Ventricular Tachyarrhythmias of Acute Myocardial Infarction Patients: A Meta-Analysis

Cardiology ◽

10.1159/000501474 ◽

2019 ◽

Vol 144 (3-4) ◽

pp. 69-75

Author(s):

Shangbo Xu ◽

Lihua Yang ◽

Danhua Hong ◽

Lan Chen ◽

Xin Wang

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Prognostic Value ◽

Meta Analysis ◽

Cochrane Library ◽

Ventricular Tachyarrhythmias ◽

Early Repolarization ◽

The Cochrane Library ◽

The Relationship

Several studies have indicated that early repolarization (ER) is a risk factor for ventricular tachyarrhythmias (VTAs) in acute myocardial infarction (AMI) patients. The prognostic values of ER detail characteristics except J-point morphology, and inferior leads ER location for VTAs are still unclear. We searched PubMed, Embase, and the Cochrane Library for eligible studies up to March 4, 2019. Studies to investigate the relationship between ER and the incidence of VTAs in AMI patients were extracted. A total of 10 studies with 2,672 participants were included in the analysis. ER significantly predicted the incidence of VTAs (odds ratio [OR] 3.62, 95% confidence intervals [CI] 2.77–4.73), regardless of the type of AMI. The presence of ER before AMI (OR 5.58, 95% CI 3.41 to 9.12) and after AMI (OR 3.02, 95% CI 2.19–4.15) increased the risk of VTAs. The prognostic value of ER for VTAs in the long follow-up (≥30 days) (OR 2.39, 95% CI 1.59–3.59) fell by half compared to the short follow-up duration (<30 days) (OR 4.97, 95% CI 3.48–7.09). Patients with ER displayed a higher risk of developing ventricular fibrillation (VF) (OR 6.94, 95% CI 3.87–12.43) than those without ER. However, neither J-point elevation with OR = 2.48 nor lateral leads’ ER location with OR = 3.83 remarkably increased the risk of VTAs in patients with AMI. ER is significantly associated with increasing risk of VTAs, particularly VF, in AMI patients. This relationship is weaker in the 30-day follow-up and is not reinforced by J-point elevation and lateral leads’ ER location.

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TP73-AS1 as a Predictor of Clinicopathological Parameters and Prognosis in Human Malignancies: A Meta and Bioinformatics Analysis

10.21203/rs.3.rs-1124245/v1 ◽

2021 ◽

Author(s):

Caizhi Chen ◽

Jingjing Wang ◽

Yeqian Feng ◽

Ye Liang ◽

Yan Huang ◽

...

Keyword(s):

Prognostic Value ◽

Meta Analysis ◽

Disease Free Survival ◽

The Cancer Genome Atlas ◽

Prognostic Indicators ◽

Cochrane Library ◽

Clinicopathological Parameters ◽

Oncogenic Signaling ◽

Poor Overall Survival ◽

The Cochrane Library

Abstract Background: LncRNA TP73-AS1 is dysregulated in various tumors but the correlation between its expression and clinicopathological parameters and/or prognoses in cancer patients is inconclusive. Here, we performed a meta-analysis to evaluate the prognostic value of lncRNA TP73-AS1 for malignancies.Methods: We systematically searched four online databases including PubMed, the Web of Science, Embase, and the Cochrane Library for eligible articles published up to June 29/2020. Odds ratios (ORs) and Pooled hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used to assess the association of TP73-AS1 expression with prognostic and clinicopathological parameters. We further validated TP73-AS1 expression in various malignancies and its potential prognostic value using the GEPIA online database. We predicted potential biological processes and relevant signal mechanisms through the public databases.Results: A total of 26 studies including 1770 patients were analyzed to evaluate the relationship between TP73-AS1 expression, clinicopathological features and prognostic indicators. The results indicated that TP73-AS1 expression markedly correlates with TNM stage, tumor size, lymph node metastasis and distant metastasis. No correlation with age, gender or differentiation was observed. TP73-AS1 overexpression was a biomarker of poor Overall survival (OS) and Disease-Free-Survival (DFS). Dysregulated TP73-AS1 expression and its prognostic value in various cancers was validated based on The Cancer Genome Atlas (TCGA). Further biological function predictions indicated that TP73-AS1 was involved in pro-oncogenic signaling.Conclusions: The upregulation of LncRNA TP73-AS1 was related to detrimental clinicopathological parameters and can be considered an indicator of poor prognosis for cancer malignancies.

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Aspiration-Sclerotherapy Versus Laparoscopic De-roofing in the Treatment of Symptomatic Renal Cysts: A Systematic review and meta-analysis

10.21203/rs.2.11406/v1 ◽

2019 ◽

Author(s):

Xueling Zhang ◽

Dehong Cao ◽

Peizhen Han ◽

Zhengju Ren ◽

Jia Wang ◽

...

Keyword(s):

Literature Search ◽

Treatment Time ◽

Renal Cyst ◽

Meta Analysis ◽

Renal Cysts ◽

Cochrane Library ◽

Significant Difference ◽

The World ◽

The Cochrane Library ◽

Comprehensive Literature Search

Abstract Background: Renal cyst is prevailing around the world and symptomatic renal cysts are recommended to be treated in the EUA guidelines. Currently, aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) are the main therapies of symptomatic renal cysts. This article aims to compare the clinical efficiency between them in the management of renal cysts through meta-analysis of comparative studies. Method: A comprehensive literature search was performed by PubMed, MEDLINE, EMBASE and the Cochrane Library to ascertain the relevant studies published up to March 2019. Articles with English full-text comparing aspiration-sclerotherapy and laparoscopic de-roofing in renal cyst treatment were included. Results: Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that although AS group had shorter treatment time (MD：-51.10; 95% CI：-73.01 to -29.20; p<0.01), radiological successful rate (RR: 0.64; 95%CI: 0.53 to 0.77) are higher in LD group, which also had less recurrence rate (RR: 4.96; 95%CI: 2.28 to 10.81; p<0.01). No statistically significant difference was showed in symptomatic successful rate (RR: 0.90; 95%CI: 0.79 to 1.03；P=0.13) and complications (RR: 2.11; 95% CI: 0.47 to 9.52; P=0.33). Conclusion: In our meta-analysis, laparoscopic de-roofing is superior to aspiration-sclerotherapy in radiological successful rate and recurrence, but the treatment time is longer.

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Comparison of diagnostic accuracy of Midkine and AFP for detecting hepatocellular carcinoma: a systematic review and meta-analysis

Bioscience Reports ◽

10.1042/bsr20192424 ◽

2020 ◽

Vol 40 (3) ◽

Cited By ~ 2

Author(s):

Qingqing Lu ◽

Jie Li ◽

Hui Cao ◽

Chenlu Lv ◽

Xiaolin Wang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Diagnostic Accuracy ◽

Hepatitis Virus ◽

Early Stage ◽

Meta Analysis ◽

Area Under The Curve ◽

Cochrane Library ◽

Sensitivity Specificity ◽

The Cochrane Library

Abstract Objective: Midkine (MDK) has been proposed as one of the most promising markers for hepatocellular carcinoma (HCC). This meta-analysis was conducted to compare the diagnostic accuracy of MDK and α-fetoprotein (AFP) for HCC. Methods: We systematically searched PubMed/MEDLINE, Ovid/EMBASE, and the Cochrane Library for all relevant studies up to 18 May 2019. The Revised Quality Assessment for Studies of Diagnostic Accuracy tool (QUADAS-2) was used to assess the methodological quality of the included studies. The sensitivity, specificity, and the area under the curve (AUC) of MDK and AFP for detecting HCC were pooled using random-effects model. Results: Seventeen studies from five articles with a total of 1122 HCC patients and 2483 controls were included. The summary estimates using MDK and AFP for detecting HCC were as follows: sensitivity, 85 vs 52%, specificity, 82 vs 94%, and AUC, 0.90 vs 0.83. The summary estimates using MDK and AFP for detecting hepatitis virus-related HCC as follows: sensitivity, 93 vs 74%, specificity, 85 vs 97%, and AUC, 0.95 vs 0.97. The summary estimates using MDK and AFP for detecting early-stage HCC were as follows: sensitivity, 83.5 vs 44.4%, specificity, 81.7 vs 84.8%, and AUC, 0.87 vs 0.52. The summary estimates using MDK for detecting AFP-negative HCC as follows: sensitivity, 88.5%, specificity, 83.9%, and AUC, 0.91. Conclusion: MDK is more accurate than AFP in diagnosing HCC, especially for early-stage HCC and AFP-negative HCC. Both MDK and AFP had excellent diagnostic performance for hepatitis virus-related HCC.

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Effect of ARID1A mutation and expression on prognosis of hepatocellular carcinoma and cholangiocarcinoma: a meta-analysis

10.21203/rs.3.rs-108182/v1 ◽

2020 ◽

Author(s):

Guangxiao Meng ◽

Lun-Jie Yan ◽

Zhao-Ru Dong ◽

Zhi-Qiang Chen ◽

Ya-Fei Yang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Web Of Science ◽

Malignant Tumors ◽

Meta Analysis ◽

Cochrane Library ◽

Mutation Carriers ◽

New Treatments ◽

The Cochrane Library ◽

The Impact ◽

The Relationship

Abstract Background: Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the most common liver malignant tumors worldwide. Investigating the molecular basis of these malignancies is vital to the development of new treatments. Recent studies have found that mutation and abnormal expression of ARID1A, are frequently shown in HCC and cholangiocarcinoma. Herein, we aimed to estimate the effects of ARID1A mutation and expression on prognosis of HCC and cholangiocarcinoma.Methods: We searched PubMed, EMBASE, Web of Science, the Cochrane Library for studies evaluating the relationship between ARID1A mutations or expression and the survival of HCC or cholangiocarcinoma patients. Meta-analysis was performed to generate a combined HR with a 95% confidence interval (CI) for overall survival (OS).Results: We identified 12 articles that evaluated the impact of ARID1A mutation or expression on the prognosis of patients with HCC or cholangiocarcinoma. Six studies provided data on HCC survival and 6 studies examined cholangiocarcinoma survival. For HCC, ARID1A mutation carriers or patients with low ARID1A expression had worse OS (HR = 1.75; 95% CI = 1.22–2.51) than non-carriers or patients with high ARID1A expression. For cholangiocarcinoma, ARID1A mutation carriers or patients with low ARID1A expression also had significantly shorter OS (HR = 3.70, 95% CI = 2.88–4.76).Conclusions: Our study suggests that ARIDIA mutation or low expression is strongly associated with poor prognosis of patients with HCC or cholangiocarcinoma, and may be considered as a potential prognostic biomarker for these patients.

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Prognostic value of PIVKA-II in hepatocellular carcinoma patients receiving curative ablation: A systematic review and meta-analysis

The International Journal of Biological Markers ◽

10.1177/1724600818760234 ◽

2018 ◽

Vol 33 (3) ◽

pp. 266-274 ◽

Cited By ~ 2

Author(s):

Dongjing Zhang ◽

Zhihong Liu ◽

Xueru Yin ◽

Xiaolong Qi ◽

Bingyun Lu ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Prognostic Value ◽

Clinical Utility ◽

Web Of Science ◽

Meta Analysis ◽

Cochrane Library ◽

Recurrence Free Survival ◽

Free Survival ◽

Hazard Ratios

Background: Several studies have been conducted to evaluate the prognostic value of prothrombin induced by vitamin K absence-II (PIVKA-II) overexpression in hepatocellular carcinoma patients treated with curative ablation. However, the results remain controversial. The purpose of this meta-analysis was to explore the correlation between PIVKA-II expression and survival outcomes in these patients. Methods: We performed a systematic literature search in PubMed, EMBASE, Medline, Cochrane Library, and Web of Science to identify the relevant articles investigating the prognostic value of PIVKA-II in patients with hepatocellular carcinoma. Combined hazard ratios (HR) and their 95% confidence intervals (CI) for overall survival and recurrence-free survival were calculated as the analysis endpoints. Results: A total of 15 cohorts encompassing 5647 patients were included. The results indicated that elevated PIVKA-II was significantly associated with poorer overall survival (HR 1.59; 95% CI 1.40, 1.82; P < 0.001) and recurrence-free survival (HR 1.76; 95% CI 1.42, 2.17; P < 0.001). Similar results were observed in the subgroup analysis based on sample size, analytical method, treatment modality, and cut-off value. Conclusions: This meta-analysis suggests that elevated PIVKA-II is a predictor of unfavorable overall survival and recurrence-free survival in hepatocellular carcinoma patients receiving curative ablation. More rigorous studies are warranted to confirm the clinical utility of PIVKA-II in determining hepatocellular carcinoma prognosis.

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