Role of TSP-1 as prognostic marker in various cancers: a systematic review and meta-analysis
Abstract Background 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 clarify the preliminary predictive value of TSP-1. Methods Twenty-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 ratio s ( 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. Results A 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). 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) and disease-free survival ( DFS )/ recurrence-free survival ( RFS ) (HR = 1.40, 95%CI: 0.77–2.53). In addition, we performed subgroup analyses which showed that high TSP-1 expression predicted poor prognosis in breast cancer and gynecological cancer. Conclusions Our findings indicated high TSP-1 expression may serve as a promising biomarker of poor prognosis and novel therapeutic target in cancers, especially in breast cancer and gynecological cancer.