Clinicopathological and prognostic significance of CXCR4 expression in osteosarcoma: a meta-analysis

Background: C-X-C Motif Chemokine Receptor (CXCR4) is an oncogene that widely studied and associated with worse clinicopathological features and prognosis outcome on many types of cancer. Beside that, significance of CXCR4 expression on clinicopathological features and prognostic on osteosarcoma (OS) require further validation. Aim: We conducted a meta-analysis to evaluate association between positive CXCR4 expression with clinicopatho-logical features, and prognosis in OS. Methods: Literature searches on Pubmed, Cochrane Library and Web of Science was conducted systematically up to December 2021 to find relevant references. Effect of CXCR4 expression on clinicopathological characteristic and prog-nostic were analyzed using Review Manager 5.4 (Cochrane Collaboration, Oxford, UK). Significance value less than 0.05 was considered statistically significant. Results: By considering inclusion and exclusion criteria, 940 patients from 12 studies were suitable to included in qualitative analysis, and 10 studies were suitable for quantitative analysis. Association between CXCR4 expression and OS clinicopathological features was found significant on metastasis (OR = 4.01, 95%CI = 1.58-10.18; p = 0.003), stage (stage III & IV vs I & II, OR = 6.52, 95%CI = 1.05-40.62; p = 0.04), and tumor primary site (femur/tibia vs other, OR = 1.60, 95%CI = 1.04-2.45; p = 0.03), but not associated with histological type, gender, and age. Furthermore, CXCR4 expression is associated with poor overall survival in OS (HR = 2.13, 95%CI = 1.78-2.55; p < 0.001). Conclusion: In conclusion, the results of our meta-analysis suggest that CXCR4 expression may be valuable as a his-topathological predictor of poor clinicopathological features and prognosis of OS.