Prognostic Factors Of Gastrointestinal Stromal Tumors:a Meta-analysis

Objective: Many factors have been mentioned in the prognosis of Gastrointestinal stromal tumors,but it is unclear,especially in clinicopathological features and expression of biomakers.We performed a meta-analysis to exploring the influence of clinicopathology and immunohistochemistry on the 5-year overall survival(OS)of gastrointestinal stromal tumors to judge the trend of GISTs.Methods: We searched the databases of Pub Med,EMBASE,Cochrane Library,Wan Fang,CNKI and Chinese VIP for eligible studies until October 2016.A total of 10 relevant articles with 1113 patients were included in the study.The relationship between clinicopathological features(tumor size,mitotic counts and risk degree)and some biomakers(CD34,CD117,DOG1 and label index of ki67 and tumor cell type)and5-year OS was evaluated using pooled odds ratios(ORs)and hazard ratio(HR)with 95%confidence intervals(CIs).We tabulated and analyzed the patient characteristics from each study,including general information such as age and gender,tumor location.Results: The results show that the 5-year OS was associated with tumor location(stomach or intestine)(OR 0.366,95%CI 0.249-0.537;p=0.000);mitotic rates(>5 or ≤5)(OR 0.309,95%CI 0.153-0.621;p=0.001);tumor cell type(spindle and epithelium cell or mixed)(OR 0.194,95%CI 0.090-0.417;p=0.000);tumor size(>5cm or ≤5cm)(OR 8.286,95%CI 4.182-16.416;p=0.000);risk degree(high risk or non-high risk)(OR4.742,95%CI 3.174-7.084;p=0.000);CD34(OR 0.619 95%CI 0.448-0.854;p=0.000)and Ki67(<5 or >5)(OR 0.517,95%CI 0.308-0.868;p=0.013).But the gender(male or female),age(<60 year old or >60 year old),tumor location(gastrointestine or others),the expression of CD117 and DOG1 had no statistically significant.In the meta-analysis,funnel plots was carried out to find the little publication bias.Sensitivity analysis showed that there was no significant heterogeneity in studies,and no study influenced the pooled OR.Conclusion: Clinicopathological and immunohistochemical value play an important role in the prognosis of gastrointestinal stromal tumors.We suggest a comprehensive assessment of clinicopathology,immunohistochemistry,drugs,surgery,and other risk factors for evaluating the prognosis of gastrointestinal stromal tumors.