Popat Sanjay, Houlston Richard S
Department of Medicine, Royal Marsden Hospital, London SW3 6JJ, United Kingdom.
Eur J Cancer. 2005 Sep;41(14):2060-70. doi: 10.1016/j.ejca.2005.04.039.
Results from studies investigating the relationship between colorectal cancer survival and chromosome 18q allelic imbalance (AI)/loss of DCC expression (LOE) have been inconsistent. We have reviewed and pooled published studies to estimate the prognostic significance of chromosome 18q status more precisely. Data from 27 studies were eligible. Survival data were pooled using standard meta-analysis techniques. Considerable variation between assessment method, marker choice, and threshold for assigning AI/LOE was observed. Pooling data from a 2189 cases from 17 studies showed significantly worse overall survival in patients with AI/LOE (HR = 2.00, 95%CI: 1.49-2.69), maintained both in the adjuvant setting (HR = 1.69, 95%CI:1.13-2.54), and also by method (HR = 1.67, 95%CI: 1.19-2.36, genotyping microsatellites; HR = 3.00, 95%CI: 1.98-4.56, immunohistochemistry). There was however evidence of heterogeneity and publication bias. Cancers with chromosome 18q loss appear to have a poorer prognosis. Prospective studies using consistent methodology are needed to precisely quantify its effect and role in patients with stage II-III disease.
关于结直肠癌生存与18号染色体等位基因失衡（AI）/DCC表达缺失（LOE）之间关系的研究结果并不一致。我们回顾并汇总了已发表的研究，以更精确地评估18号染色体状态的预后意义。27项研究的数据符合要求。使用标准的荟萃分析技术汇总生存数据。观察到评估方法、标志物选择以及确定AI/LOE的阈值之间存在相当大的差异。汇总来自17项研究的2189例患者的数据显示，AI/LOE患者的总生存期明显更差（HR = 2.00，95%CI：1.49 - 2.69），在辅助治疗环境中（HR = 1.69，95%CI：1.13 - 2.54）以及按方法（HR = 1.67，95%CI：1.19 - 2.36，基因分型微卫星；HR = 3.00，95%CI：1.98 - 4.56，免疫组织化学）均保持如此。然而，存在异质性和发表偏倚的证据。18号染色体缺失的癌症似乎预后较差。需要采用一致方法的前瞻性研究来精确量化其在II - III期疾病患者中的作用和影响。
