摘要
目的系统评价CXCR4与非小细胞肺癌(NSCLC)患者临床病理特征及预后的关系。方法计算机检索PubMed、EMbase、Cochrane Library、中国知网、万方和中国生物医学文献数据库,搜索公开发表的关于CXCR4表达与NSCLC预后相关性的队列研究,检索时限均为从建库至2018年5月31日。由2名研究者独立进行文献筛选、资料提取和评价偏倚风险,采用Stata 12.0软件进行Meta分析。结果最终纳入20篇文献,共2124例NSCLC患者。腺癌患者CXCR4阳性表达率为51.8%(337/650),鳞状细胞癌患者为50.3%(224/445),差异有统计学意义(RR=1.22,95%CI 1.09~1.38,P=0.001)。Ⅰ~Ⅱ期肺癌患者CXCR4阳性表达率为41.1%(317/772),Ⅲ~Ⅳ期患者为57.0%(348/610),差异有统计学意义(RR=0.62,95%CI 0.55~0.69,P<0.01)。远处转移患者CXCR4阳性表达率为55.3%(268/485),无远处转移患者为39.2%(256/653),差异有统计学意义(RR=1.78,95%CI 1.54~2.06,P<0.01)。CXCR4的表达与原发肿瘤的大小及浸润程度无关,T1~T2和T3~T4患者CXCR4阳性表达率分别为41.0%(215/524)和53.8%(84/156)(RR=0.71,95%CI 0.60~0.84,P=0.053)。CXCR4阳性患者的总生存率低于阴性患者,差异有统计学意义(30.1%比66.9%,RR=0.45,95%CI 0.30~0.61,P<0.01)。CXCR4阳性患者无病生存率较阴性患者低(38.0%比20.1%,RR=1.89,95%CI 1.45~2.47,P=0.002)。结论NSCLC患者病理类型、肿瘤分期和远处转移情况与CXCR4表达水平相关。CXCR4在肿瘤组织中的表达水平对NSCLC患者的预后具有预测价值,CXCR4表达水平越高,患者总生存率、无病生存率越低。
Objective To systematically evaluate the relationship between CXCR4 and the clinicopathological characteristics and prognosis of patients with non-small cell lung cancer(NSCLC).Methods The PubMed,EMbase,Cochrane Library,CNKI,Wanfang and China Biology Medicine databases were searched by the computer to collect the publicly published cohort studies on the correlation between CXCR4 expression and prognosis of NSCLC.The retrieval time was from the establishment of the database to May 31,2018.Literature screening,data extraction and risk of bias were performed independently by two reviewers,and Meta-analysis was performed by using Stata 12.0 software.Results Finally,20 studies were included,with a total of 2124 NSCLC patients.The positive expression rate of CXCR4 in patients with adenocarcinoma was 51.8%(337/650)and it was 50.3%(224/445)in patients with squamous cell carcinoma,the difference was statistically significant(RR=1.22,95%CI 1.09-1.38,P=0.001).The positive expression rate of CXCR4 in patients with stageⅠ-Ⅱwas 41.1%(317/772),and the rate was 57.0%(348/610)in patients with stageⅢ-Ⅳ,the difference was statistically significant(RR=0.62,95%CI 0.55-0.69,P<0.01).The positive expression rate of CXCR4 in patients with distant metastasis was 55.3%(268/485),and the positive rate of CXCR4 in those without distant metastasis was 39.2%(256/653),the difference was statistically significant(RR=1.78,95%CI 1.54-2.06,P<0.01).The expression of CXCR4 was not related to the size and invasion of the primary tumor,the positive expression rates of CXCR4 in T1-T2 and T3-T4 patients were 41.0%(215/524)and 53.8%(84/156)(RR=0.71,95%CI 0.60-0.84,P=0.053).The overall survival rate of patients with CXCR4-positive was lower than that of patients with CXCR4-negative,and the difference was statistically significant(30.1%vs.66.9%,RR=0.45,95%CI 0.30-0.61,P<0.01).The disease-free survival rate of patients with CXCR4-positive was lower than that of patients with CXCR4-negative(38.0%vs.20.1%,RR=1.89,95%CI 1.45-2.47,P=0.002).Conclusions The pathological type,tumor staging and distant metastasis of NSCLC patients are correlated with CXCR4 expression level.The expression level of CXCR4 in tumor tissues has a predictive value for the prognosis of NSCLC patients;and the higher the expression level of CXCR4 is,the lower the overall survival and disease-free survival rates are.
作者
刘倩
汤建华
张志华
Liu Qian;Tang Jianhua;Zhang Zhihua(Department of Clinical Pharmacology,the First Affiliated Hospital of Hebei Northern College,Zhangjiakou 075000,China;Department of Respiratory Medicine,the First Affiliated Hospital of Hebei Northern College,Zhangjiakou 075000,China)
出处
《肿瘤研究与临床》
CAS
2020年第2期111-118,共8页
Cancer Research and Clinic
基金
河北省医学科学研究重点课题(20180828)。
