title: The Clinical Implications of Human Telomerase Reverse Transcriptase Expression in Grade and Prognosis of Gliomas: a Systematic Review and Meta-analysis.
abstract: Human telomerase reverse transcriptase (hTERT), a ribonucleoprotein, is reported as an important complex, which is required for stability of DNA molecular structure at the rear of the chromosome. Until now, hTERT has been linked to cell immortalization and tumorigenesis. A couple of articles have been published about the telomerase function in the gliomas; however, these results are conflicting in some degree. Thus, it is crucial to perform a meta-analysis to identify their real actions. We included eligible articles, and estimated odds ratios (ORs) with 95 % confidence intervals (95 % CIs). In our meta-analysis, all 15 eligible articles included 932 patients. Results from 10 studies on WHO grade showed that high hTERT gene or protein expression in glioma tissues was obviously related to high WHO grade (III + IV) (OR 2.45, 95 % CI 1.92-3.13; p = 0.000). What is more, hTERT expression was not associated with old age (OR 0.91, 95 % CI 0.72-1.16; p = 0.448) as well as gender (OR 1.06, 95 % CI 0.82-1.37; p = 0.664). Importantly, hTERT expression was significantly associated with 5-year overall survival (OS; n = 3; hazard ratio (HR) 2.25, 95 % CI 1.36-3.70; p = 0.002) of glioma patients. No heterogeneity was found in all studies. In conclusion, this meta-analysis suggests that hTERT is significantly associated with high glioma grade and poor 5-year overall survival, and pathological test of hTERT mRNA and protein in glioma tissues should be suggested as criteria of glioma grade in the clinical practice.
authors.affiliation: Dean's Office, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Special Inspection, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Huiying
authors.initials: H
authors.lastname: Li
authors.affiliation: The Sixth Department of Intern Medicine, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Jihong
authors.initials: J
authors.lastname: Liu
authors.affiliation: Dean's Office, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Feng
authors.affiliation: Department of Pathology, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Man
authors.initials: M
authors.lastname: Feng
authors.affiliation: Department of Nursing, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Baoyu
authors.initials: B
authors.lastname: Lv
authors.affiliation: Department of Gynecology, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Shaomei
authors.initials: S
authors.lastname: Cheng
authors.affiliation: Department of Pathology, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong, China. yangxiangshan163@163.com.
authors.forename: Xiangshan
authors.initials: X
authors.lastname: Yang
keywords: Gliomas; Grade; HTERT; Meta-analysis; Prognosis