title: Kallikrein expression as a prognostic factor in ovarian cancer: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Kallikrein is considered as a mediator of tumorigenesis. Various studies examing the relationship between high kallikrein expressions with the clinical outcome in patients with ovarian cancer have yielded controversial conclusions.
  
  
  METHODS
  We conducted a meta-analysis of 10 studies (N=1478) that evaluated the relationship between positive kallikrein expression and overall survival and progression-free survival (PFS). Data were analyzed with random effect and combined hazard ratios (HR) by STATA software.
  
  
  RESULTS
  Positive kallikrein expression was significantly associated with worse OS (HR for OS was 2.01, 95%CI: 1.68-2.34, p<0.05). Subgroup analysis showed that kallikrein detected by RT-PCR was related with OS (HR=2.51, 95%CI: 2.16-2.86, p<0.05), as well as by nonY-PCR methods (HR=1.6, 95%CI: 1.08-2.12, p<0.05). The heterogeneity among studies was significant (I2-91%, p=0.000). Begg's and Egger's test showed p=0.813 and p=0.938, respectively. The estimated HR for PFS was 1.83, 95%CI: 1.51-2.14, p<0.05). The heterogeneity among studies was significant (I2=88.9%, p=0.000). Begg's and Egger's test showed p=0.93 and p=0.88, respectively. Furthermore, confunnel plot (contour-enhanced funnel plot) was undertaken which also showed absence of publication bias for both OS and PFS.
  
  
  CONCLUSIONS
  Although the presence of some modest bias cannot be avoided, positive kallikrein expression seems to be associated with worse OS and PFS in patients with ovarian cancer.
authors.affiliation: Department of Ultrasound, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
authors.forename: Man
authors.initials: M
authors.lastname: Lu
authors.forename: Qiaodan
authors.initials: Q
authors.lastname: Zhou
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007610:Kallikreins / Q000032:analysis* / Q000235:genetics; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000737:chemistry* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D007610:Kallikreins