Prognostic value of Midkine expression in patients with solid tumors: a systematic review and meta-analysis

BACKGROUND: Accumulated studies have shown the important role of Midkine (MDK) protein in various solid tumors and indicated its correlation with patients’ survival. This meta-analysis was performed to further explore the prognostic value of MDK expression in solid tumors. MATERIALS AND METHODS: We collected the literatures through searching PubMed, Embase and the Cochrane Library (last up to April 10, 2017) to assess the effect of MDK on survival in solid tumor patients. The STATA 12.0 software was used for the meta-analysis. Fixed-effects models or random-effects models were used to estimate the pooled hazard ratios (HRs) for overall survival (OS). RESULTS: A total of 2097 patients from 17 observational studies were summarized. High expression of MDK was notably associated with worse OS in solid tumor patients. (pooled HR = 1.96; 95% CI = 1.67–2.31). The subgroup analysis of tumor type demonstrated negative impact of elevated MDK on OS in most solid tumor patients (P < 0.05), while MDK had no relevance with OS in the patients with OSCC (pooled HR = 1.68; 95% CI = 0.84–3.36; P = 0.145) or HNSCC (pooled HR = 1.56; 95% CI = 0.96–2.51; P = 0.075). CONCLUSIONS: The present meta-analysis clarifies that MDK is a potential prognostic biomarker in solid tumor patients. Future large-scale prospective clinical trials are needed to determine the prognostic value of MDK in solid tumor patients.