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Open Access Research article

Prognostic significance of glypican-3 in hepatocellular carcinoma: a meta-analysis

Wei-Kai Xiao1, Chao-Ying Qi2, Dong Chen1, Shao-Qiang Li1*, Shun-Jun Fu1, Bao-Gang Peng1 and Li-Jian Liang1

Author Affiliations

1 Department of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan Er Road, Guangzhou 510080, China

2 The Operating Center, the First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan Er Road, Guangzhou 510080, China

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BMC Cancer 2014, 14:104  doi:10.1186/1471-2407-14-104

Published: 18 February 2014

Abstract

Backgrounds

Glypican-3(GPC3) has been implicated in tumor development and progression for several years. However, the prognostic significance of GPC3 expression in patients with hepatocellular carcinoma (HCC) is controversial. We performed a meta-analysis of available studies to assess whether GPC3 can be used as a prognostic factor in patients with HCC.

Methods

We searched PubMed and Ovid EBM Reviews databases and evaluated the reference list of relevant articles for studies that assessed the prognostic relevance of GPC3 in patients with HCC. Meta-analysis was performed using hazard ratio (HR) or odds ratio (OR) and 95% confidence intervals (95% CIs) as effect measures.

Results

A meta-analysis of eight studies included 1070 patients was carried out to evaluate the association between GPC3 and overall survival (OS) and disease-free survival (DFS) in HCC patients. The relation between GPC3 and tumor pathological features was also assessed. Our analysis results indicated that high GPC3 expression predicted poor OS (HR: 1.96, 95% CI: 1.51–2.55) and DFS (HR: 1.99, 95% CI: 1.57-2.51) of patients with HCC. GPC3 overexpression was significantly associated with high tumor grade (OR: 3.30, 95% CI: 2.04–5.33), late TNM stage (OR: 2.26, 95% CI: 1.00–5.12), and the presence of vascular invasion (OR: 2.43, 95% CI: 1.23–4.82).

Conclusions

GPC3 overexpression indicates a poor prognosis for patients with HCC, and it may also have predictive potential for HCC invasion and metastasis.

Keywords:
Glypican-3; Hepatocellular carcinoma; Prognosis