Data from Tissue Biomarkers for Prognosis of Prostate Cancer: A Systematic Review and Meta-analysis

Background: Although numerous investigators have made efforts to assess prognostic biomarkers of prostate cancer, no biomarker has been recommended for clinical practice.

Methods: According to REMARK (Reporting recommendations for tumor marker prognostic studies) and MISFISHIE (Minimum information specification for in situ hybridization and immunohistochemistry experiments) guidelines, the published articles of immunohistochemistry-based prognostic biomarkers on prostate cancer were extracted and pooled.

Results: Ninety-three prognostic biomarkers from 92 high-quality cohort studies were included in this meta-analysis. Our analysis reveals some promising independent prognostic biomarkers, including Ki-67 [all-cause mortality (ACM) HR, 1.85; 95% confidence interval (CI), 1.06–3.25; PSM HR, 1.82; 95% CI, 1.42–2.34; DFS HR, 1.51; 95% CI, 1.31–1.75]; Bcl-2 (ACM HR, 2.14; 95% CI, 1.27–3.58; PSM HR, 1.61; 95% CI, 1.01–2.57; DFS HR, 3.86; 95% CI, 2.14–6.96); CD147 (ACM HR, 2.63; 95% CI, 1.19–5.81; DFS HR, 5.84; 95% CI, 3.41–9.99); COX-2 (PSM HR, 7.6; 95% CI, 0.7–80.1; DFS HR, 7.9; 95% CI, 2.62–23.83); ALDH1A1 (ACM HR, 1.73; 95% CI, 1.163–2.527; PSM HR, 1.05; 95% CI, 1.028–1.107), and FVIII (ACM HR, 1.76; 95% CI, 1.19–2.60; PSM HR, 1.01; 95% CI, 1.01–1.02).

Conclusions: Our analysis identified a subset of biomarkers (Ki-67, Bcl-2, CD147, COX-2, ALDH1A1, and FVIII) that may have prognostic value for predicting the outcome of patients with prostate cancer.

Impact: These reliable prognostic biomarkers will improve the clinical management of patients with prostate cancer. Cancer Epidemiol Biomarkers Prev; 23(6); 1047–54. ©2014 AACR.