J Cancer 2019; 10(6):1528-1537. doi:10.7150/jca.28229 This issue

Research Paper

Prognostic Value of XIAP Level in Patients with Various Cancers: A Systematic Review and Meta-Analysis

Xian Gao1*, Lei Zhang2*, Yong Wei3*, Yiqi Yang1, Jun Li1, Hao Wu1, Yongmei Yin 1✉

1. Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
2. Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210009, China.
3. Department of Urology, Nanjing Gaochun People's Hospital, Nanjing, 211300, China
*The authors contributed equally to this work.

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Gao X, Zhang L, Wei Y, Yang Y, Li J, Wu H, Yin Y. Prognostic Value of XIAP Level in Patients with Various Cancers: A Systematic Review and Meta-Analysis. J Cancer 2019; 10(6):1528-1537. doi:10.7150/jca.28229. Available from https://www.jcancer.org/v10p1528.htm

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Background: X-linked inhibitor of apoptosis protein (XIAP) plays an important role in cancer pathogenesis, which has been found to be overexpressed in multiple human cancers and associated with survival rates. Herein, we performed a meta-analysis to explore the predictive value of XIAP level in patients with various solid tumors.

Methods: Relevant articles exploring the relationship between XIAP expression and survival of cancer patients were retrieved in PubMed, PMC, EMBASE and Web of Science published from 2001 to 2018. The combined hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate the significance.

Results: A total of 6554 patients from 40 articles were included in this meta-analysis. It was shown in 37 studies with 4864 cases that the over-expression of XIAP was associated with poorer overall survival (OS) (combined HR=1.61, 95% CI: 1.33-1.96). Meanwhile, 8 studies with 1862 cases revealed that elevated XIAP level predicted shorter disease-free survival (DFS) (HR=2.17, 95% CI: 1.03-4.59). Subgroup analyses showed that higher XIAP detection was related to worse OS in gastric cancer (HR=1.42, 95% CI: 1.18-1.72) and head and neck cancer (HNC) (HR=2.97, 95% CI: 1.97-4.47).

Conclusion: Our results suggested that elevated XIAP level seemed to represent an unfavorable prognostic factor for clinical outcomes in cancer patients. However, there were limited studies describing the association between XIAP expression and clinical prognosis in each different type of tumors. Therefore, concrete roles of XIAP in various cancers need to be further explored.

Keywords: XIAP, cancer, survival, meta-analysis