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

BACKGROUND: In recent years, an increasing number of studies has been published analyzing the possible prognostic utility of glypican-3 (GPC3) in hepatocellular carcinoma (HCC), but the results are still controversial. The aim of this meta-analysis was to evaluate possible association between GPC3 expression and patients’ survival. METHODS: Relevant publications which assessed GPC3 expression with survival outcome in HCC patients were searched from Pubmed, Embase, Web of Science, and the Cochrane library. Survival outcome (odds ratios or hazard ratios) was synthesized with a fixed or random effects meta-analysis. Publication bias and sensitivity analyses were also conducted. Statistical analysis was performed by STATA 12.0 and Review Manager software 5.3. RESULTS: Fifteen studies including 2336 HCC cases were analyzed systematically in our meta-analysis. The main results showed that GPC3 high expression was significantly associated with later tumor stage, higher tumor grade, presence of vascular invasion, shortened overall survival, and disease-free survival. Subgroup analyses for GPC3 on HCC overall survival according to the studies categorized by sample size, follow-up period, and cut-offs were also conducted. CONCLUSION: Our findings suggested that GPC3 may play a role in cancer invasion and progression and may be related to poor prognosis of HCC. Further mechanical research or multicenter cohort studies are needed to confirm these findings.