Benefit of Serum Thymidine Kinase 1 Concentration for Risk Assessment from Gastric Neoplasms Progression to Carcinomas: A Systematic Review and Meta-analysis

Background: Human Thymidine kinase 1 (hTK1), a key enzyme involved in the DNA synthesis during S-phase of the cell cycle and upregulation of cell proliferation, thus it is reliable tumor proliferating biomarker for assessment of tumor proliferation rate in serum and in tissue in oncology. This meta-analysis is investigation whether the serum TK1 concentration（STK1p）based on hTK1-IgY-polyclonal-antibody can provide a benefit for risk assessment from gastric neoplasm progression to gastric carcinoma (GC) as well as for evaluation of treatment effect in GC. 1.2. Methods: Relevant studies were identified from the following electronic databases: PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang, the Chongqing VIP Chinese Science and Technology Periodical Database and Chinese Biomedical Literature Database from May 1, 2008, until November 30, 2021. Study quality was evaluated by the modified Newcastle-Ottawa Scale. Pooled estimates of weighted mean difference (MD), sensitivity analyses and publication bias were evaluated using Review manager and STATA software. RESULTS: Twenty-seven studies included to 1,909 GCs and 1,229 neoplasms (superficial gastritis, chronic gastritis, atrophic and gastric ulcers) and 2,260 tumor-frees. The results showed that STK1p levels increased significantly in the following manner (P<.0.006): tumor-free < superficial gastritis < chronic gastritis < atrophic gastritis < gastric ulcer < GC. The STK1p value of the GCs one-month-post-surgery decline significantly by 66% compared to pre-surgery. 1.3. Conclusion: STK1p value has the potential to be an early risk warning indicator for early gastric neoplasms progression to GCs and to be a helpful index for monitoring the response to surgery. 1.4. Core Tip: In spite of improvements in diagnosis and treatment the long-term survival rate for a large number of GCs is still dismal. Hence, it is important to explore serum biomarkers for early prediction of risk gastric neoplasms into GCs. In this meta-analysis, the STK1p as a prognostic biomarker was investigated showed significantly higher in GCs compere to different neoplasm and tumor-free people and was significantly reduced one-month post-surgery. It demonstrates that STK1p as tumor proliferating serum-biomarker, can be not only used for early risk gastric neoplasm progression and evaluation of treatment effect in GC patients, but also for a variety of other tumor types in clinical setting.