Abstract 376P
Background
Nucleolin (NCL) is one of several potential molecular biomarkers that have been suggested as predictors for pediatric intracranial ependymomas. However, few studies have assessed whether NCL is an optimal prognostic marker to predict outcome in pediatric intracranial ependymoma. Thus, this systematic review and meta-analysis aimed to examine the prognostic role of NCL in predicting the outcome of patients with intracranial ependymoma.
Methods
An independent search was conducted by each reviewer (JH and RS) on 4th May 2021 from ScienceDirect, PubMed, Europe PMC, and Cochrane Central Database. The terms nucleolin, NCL, outcome, prognosis, ependymoma, and ependymomas were used as keywords. Publications of English language, children population less than 18 years of age, WHO-graded ependymoma, and report the critical exposure were included. Publications of case reports, letters to the editor, animal studies, and preprints were not included. NCL as a predictor for ependymoma outcome, which provides for relapse-free survival (RFS) and overall survival (OS), was the critical exposure. The OS referred to a period of 5 years. In this study, two groups of NCL expression were used: high and low, with a cutoff of 50% considered common expression. Hazard ratio (HR) was used as a pooled measure. Quality of each studies was assessed using the Newcastle-Ottawa Scale (NOS) and GRADE.
Results
A total of 5 retrospective observational studies consisting of 443 ependymoma patients were included. All 5 included studies are good in quality and showed that NCL expression can predict the outcome for pediatric intracranial ependymoma patients. Our meta-analysis showed that high expression of NCL had a hazard ratio (HR) of 3.11 [1.8, 5.4], P = 0.009; I2 = 70% for RFS and 240.19 [21.48, 2686.12], P = 0.04; I2 = 63% for OS within 5 years. Based on GRADE, the result of this systematic review and meta-analysis proved to be moderate in quality as there is no inconsistency and variability in results with minimal publication biases.
Conclusions
Current studies showed that overexpression of NCL was related to a poor prognosis in patients with intracranial ependymoma. Further studies with prospective design and larger samples are required.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
J.H. Wijaya.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.