Introduction
Materials and methods
Search strategy and study selection
Definitions and data extraction
Quality assessment of primary studies
Statistical analysis
Results
The study inclusion procedure and study characteristics
First author | Year | Origin country | No. of patients | Median/mean age (year) | WHO grade | Detect method | Cut off level | Survival end points | Follow up period | Survival analysis | Adjusted variables |
---|---|---|---|---|---|---|---|---|---|---|---|
Ardebili [10] | 2011 | Slovenia | 24 | mean 60 | IV | QRT-PCR | 30 000 (─, 2-ΔΔCt > 30.000) | OS | NR | univariate (KM) | NR |
Kase [11] | 2013 | Estonia | 42 | 30–77 | IV | IHC | median | OS | NR | multivariate | Radiotherapy dose, Chemotherapy, Karnofsky performance score |
Kim [12] | 2011 | Korea | 88 | mean 54.9 (13–80) | IV | IHC | 50 % | OS | mean 13.9 months (1–53) | multivariate | age, sex, Karnofsky performance scale (KPS) score, extent of removal, chemoradiotherapeutic modality, temozolomide modality, after temozolomide therapy and stem cell marker expression |
PFS | |||||||||||
Melguizo [13] | 2012 | Italy | 75 | 24–81 | IV | IHC | 25 % | OS | NR | multivariate (KM) | NR |
PFS | |||||||||||
Metellus [14] | 2011 | France | 48 | mean 60.1 ± 9.2 | IV | QPCR | 1.03 | OS | Median 18.9 months | multivariable | Age, extent of surgery, MGMT status (MethyLight) |
PFS | |||||||||||
Shibahara [15] | 2013 | Japan | 112 | Media 57 (7–77) | IV | WB | CD133/b-actin ratio = 1 | OS | Median 25.7 months (3–152) | multivariable | Ki67 LI (≥35 %), 9p homozygous deletion and 10q loss |
Shin [16] | 2013 | Korea | 67 | NR | IV | IHC | 50 % | OS | NR | multivariable | status |
PFS | |||||||||||
Zeppernik [17] | 2008 | Germany | 48 | NR | II–III | IHC | 1 % | OS | mean 86 months (±39) | multivariate | age, WHO grade and extent of resection |
PFS | |||||||||||
Dahlrot [18] | 2014 | Denmark | 25 | NR | II | IF | median | OS | Media 12 months | multivariate | age, performance status (PS) and IDH1 status |
PFS | |||||||||||
Dahlrot [18] | 2014 | Denmark | 26 | NR | III | IF | median | OS | Media 12 months | multivariate | age, performance status (PS) and IDH1 status |
PFS | |||||||||||
Dahlrot [18] | 2014 | Denmark | 185 | NR | IV | IF | median | OS | Media 12 months | multivariate | age, performance status (PS) and IDH1 status |
PFS |
First author | Year | Origin country | No. of patients | Median/mean age (year) | WHO grade | Detect method | Cut off level | Survival end points | Follow up period | Survival analysis | Adjusted variables |
---|---|---|---|---|---|---|---|---|---|---|---|
Hatanpa [19] | 2014 | USA | 50 | median 37.5 years (20–66) | II–III | IHC | median | OS | 4.3 year | multivariate (KM) | nestin, IDH, WHO grade, oligodendroglioma component (astrocytoma or oligoastrocytoma), MIB-1, age, sex, extent of resection and type of adjuvant, therapy |
Milde [20] | 2012 | Russia | 379 | NR | II–III | IHC | 50 % | OS | median 53 months | multivariate | cytogenetic group only, or cytogenetic group and posterior fossa group |
PFS | |||||||||||
wan [21] | 2011 | Germany | 283 | NR | II–IV | IHC | median | OS | Mean 11.21 ± 4.26 years | multivariate | WHO grade, patient age at diagnosis and extent of resection |
Kim [12] | 2011 | Korea | 88 | mean 54.9 years (13–80) | IV | IHC | 50 % | OS | mean 13.9 (1–53) months | multivariate | age, sex, KPS, extent of removal, chemoradiotherapeutic modality, temozolomide modality, after temozolomide therapy and stem cell marker expression |
PFS | |||||||||||
Arai [22] | 2012 | Japan | 64 | median 55 years (11–79) | III–IV | IHC | 60 % | OS | 1–67 months | KM | NR |
Dahlrot [18] | 2014 | Denmark | 25 | NR | II | IF | median | OS | Media 12 months | multivariate | age, performance status (PS) and IDH1 status |
PFS | |||||||||||
Dahlrot [18] | 2014 | Denmark | 26 | NR | III | IF | median | OS | Media 12 months | multivariate | age, performance status (PS) and IDH1 status |
PFS | |||||||||||
Dahlrot [18] | 2014 | Denmark | 185 | NR | IV | IF | median | OS | Media 12 months | multivariate | age, performance status (PS) and IDH1 status |
CD133 expression and OS in gliomas
Comparison variables | Overall survival | Progression-free survival | ||||
---|---|---|---|---|---|---|
Number of studies, Heterogeneity (I2 statistics; %) | HR 95 % CI, P value | Interaction, P value | Number of studies, Heterogeneity (I2 statistics; %) | HR 95 % CI, P value | Interaction, P value | |
Total | 11 (77.8) | 1.69 (1.16–2.47), 0.006 | NA | 8 (68.2) | 1.64 (1.12–2.39), 0.010 | NA |
Origin country | ||||||
Europe | 8 (81.0) | 1.63 (1.03–2.61), 0.039 | 0.030 | 6 (76.5) | 1.74 (1.06–2.83), 0.027 | 0.579 |
Asian | 3 (42.5) | 1.85 (1.02–3.35), 0.044 | 2 (0.0) | 1.37 (0.86–2.18), 0.188 | ||
Sample size | ||||||
>50 | 4 (77.4) | 1.45 (0.91–2.31), 0.116 | 0.000 | 3 (0.0) | 1.37 (1.01–1.73), 0.009 | 0.092 |
≤50 | 7 (67.6) | 1.94 (1.07–3.54), 0.030 | 5 (77.0) | 1.99 (0.94–4.22), 0.073 | ||
Follow up period | ||||||
1,>media 12months | 4 (74.1) | 2.48 (1.13–5.45), 0.024 | 0.000 | 3 (86.7) | 2.64 (0.98–7.11), 0.054 | 0.060 |
2,≤media 12months | 3 (43.0) | 0.90 (0.54–1.49), 0.678 | 3 (0.0) | 1.12 (0.79–1.57), 0.530 | ||
3,No Referreed | 4 (0) | 2.11 (1.52–2.93), 0.000 | 2 (0.0) | 1.64 (1.19–2.27), 0.003 | ||
Median/mean age y | ||||||
Referred | 6 (0.0) | 1.85 (1.45–2.37), 0.000 | 0.000 | 3 (0.0) | 1.59 (1.24–2.04), 0.000 | 0.713 |
No Referred | 5 (79.8) | 1.57 (0.70–3.55), 0.274 | 5 (80.8) | 1.79 (0.81–3.97), 0.153 | ||
Test method | ||||||
IHC | 5 (64.8) | 2.16 (1.25–3.73), 0.006 | 0.000 | 4 (80.9) | 2.25 (1.11–4.58), 0.025 | 0.122 |
Others | 6 (71.2) | 1.37 (0.85–2.22), 0.202 | 4 (20.4) | 1.31 (0.93–1.84), 0.122 | ||
Cut‑off level | ||||||
1:median | 4 (61.4) | 1.09 (0.66–1.79) 0.748 | 0.000 | 3 (0.0) | 1.12 (0.79–1.57), 0.530 | 0.024 |
2:others | 7 (51.3) | 2.17 (1.44–3.27), 0.000 | 5 (74.5) | 2.07 (1.25–3.43), 0.005 | ||
WHO grade | ||||||
IV | 8 (76.3) | 1.73 (1.20–2.50), 0.004 | 0.915 | 5 (0.00) | 1.46 (1.19–1.80), 0.000 | 0.143 |
II–III | 3 (87.0) | 2.38 (0.30–18.82), 0.411 | 3 (88.1) | 2.17 (0.42–11.28), 0.355 |
CD133 expression and PFS in gliomas
Nestin expression and OS in gliomas
Comparison variables | Overall survival | Progression-free survival | ||||
---|---|---|---|---|---|---|
Number of studies, Heterogeneity (I2 statistics; %) | HR 95 % CI, P value | Interaction, P value | Number of studies, Heterogeneity (I2 statistics; %) | HR 95 % CI, P value | Interaction, P value | |
Total | 8 (75.8) | 1.75 (1.19–2.58), 0.004 | NA | 5 (71.5) | 1.55 (0.96–2.51), 0.074 | NA |
Origin country | ||||||
Europe | 5 (73.1) | 1.52 (1.04–2.21), 0.029 | 0.014 | 4 (74.1) | 1.76 (0.98–3.14), 0.057 | 0.142 |
Asian | 2 (81.8) | 1.92 (0.43–8.62), 0.393 | 1 (NA) | 1.55 (0.96–2.51), 0.973 | ||
USA | 1 (NA) | 13.42 (2.56–70.34), 0.002 | ||||
Sample size | ||||||
>50 | 5 (71.6) | 1.41 (1.00–1.98), 0.051 | 0.005 | 3 (82.6) | 1.39 (0.77–2.50), 0.277 | 0.322 |
≤50 | 3 (71.2) | 3.61 (0.99–13.17), 0.052 | 2 (36.5) | 2.14 (0.85–5.35), 0.105 | ||
Follow up period | ||||||
1,>media 12months | 2 (68.7) | 4.96 (1.08–22.78), 0.040 | 0.001 | 1 (NA) | 2.40 (1.60–3.40), 0.000 | 0.008 |
2,≤media 12months | 3 (68.8) | 1.64 (0.74–3.67), 0.225 | 3 (55.4) | 1.49 (0.76–2.94), 0.246 | ||
3,No Referreed | 3 (66.8) | 1.35 (0.77–2.38), 0.300 | 1 (NA) | 1.01 (0.57–1.79), 0.973 | ||
Median/mean age y | ||||||
Referred | 3 (83.4) | 3.36 (0.72–15.61), 0.123 | 0.154 | 1 (NA) | 1.01 (0.57–1.80), 0.973 | 0.142 |
No Referred | 5 (75.8) | 1.52 (1.04–2.21), 0.029 | 4 (74.7) | 1.76 (0.98–3.14), 0.057 | ||
Test method | ||||||
IHC | 5 (82.1) | 2.11 (1.10–4.04), 0.025 | 0.671 | 2 (83.6) | 1.60 (0.69–3.73), 0.275 | 0.063 |
Others | 3 (68.8) | 1.64 (0.74–3.67), 0.225 | 3 (55.4) | 1.49 (0.76–2.51), 0.246 | ||
Cut‑off level | ||||||
1:median | 5 (74.1) | 1.55 (1.00–2.42), 0.050 | 0.021 | 3 (55.4) | 1.49 (0.76–2.94), 0.246 | 0.063 |
2:others | 3 (75.6) | 2.10 (0.88–5.00), 0.093 | 2 (83.6) | 1.60 (0.69–3.73), 0.275 | ||
WHO grade | ||||||
IV | 2 (0.0) | 1.09 (0.83–1.44), 0.518 | 0.000 | 2 (0.00) | 1.04 (0.77–1.41), 0.808 | 0.000 |
II–III | 4 (57.2) | 3.11 (1.45–6.67), 0.004 | 3 (0.00) | 2.34 (1.68–3.27), 0.000 |