The Clinical Implications of Transforming Growth Factor Beta in Pathological Grade and Prognosis of Glioma Patients: A Meta-Analysis

The transforming growth factor beta (TGF-β) pathway plays a key role in oncogenesis of advanced cancers. However, the effects of TGF-β pathway on gliomas are still controversial. So, it is essential to conduct a meta-analysis to determine their correlations. Eligible studies were included, and then odds ratios (ORs), standard mean differences (SMDs), and hazard ratios (HRs) with 95 % confidence intervals (95% CIs) were estimated. Funnel plots were available for evaluation of publication bias. In this meta-analysis, all 14 eligible studies involving 875 patients were included and conducted in China. Six studies with dichotomous data revealed altered TGF-β expression in glioma tissues was closely associated with high WHO grade (III + IV) (OR 4.39, 95% CI 2.90-6.63; p = 0.000), meanwhile, seven studies with continuous data also demonstrated TGF-β expression intensity extremely related to high grade (SMD -2.44, 95% CI -2.71, -2.16; p = 0.000). To our interest, TGF-β expression was associated with old age (OR 0.59, 95% CI 0.36-0.93; p = 0.025) rather than gender (OR 1.04, 95% CI 0.64-1.67; p = 0.884). Besides, TGF-β expression significantly correlated to 3-year-OS (n = 2; HR 2.53, 95% CI 1.18-5.41; p = 0.017) rather than 5-year-OS (n = 1; HR 1.04, 95% CI 0.66-1.64; p = 0.872) in glioma patients. No heterogeneity and publication bias were observed across all studies. Taken together, the present meta-analysis testifies TGF-β is potently associated with high grade and poor 3 years prognosis, and TGF-β test combined with survivin [1 Mol Neurobiol] and MMP9 [2 Mol Neurobiol] in glioma tissues should be clinically recommended as criteria of glioma grade in department of pathology.