Fan Jiang, Wang Lei, Jiang Ge-Ning, He Wen-Xin, Ding Jia-An
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, 507 Zheng Min Road, Yangpu District, Shanghai 200433, PR China.
Lung Cancer. 2008 Jul;61(1):91-6. doi: 10.1016/j.lungcan.2007.11.011. Epub 2008 Jan 14.
The prognostic value of survivin for survival of patients with non-small cell lung cancer (NSCLC) remains controversial. The authors performed a meta-analysis of the literatures in order to clarify its impact. Published studies were identified using an electronic search in order to aggregate the available survival results. To be eligible, a study had to have dealt with survivin assessment in NSCLC patients on the primary site and have analyzed survival according to survivin expression. There were 10 eligible studies and data from eight studies where non-location specific immunohistochemistry (IHC) definition system, in situ hybridization (ISH) and RT-PCR used were combined to present the impact of survivin on overall survival (OS) of NSCLC. The level of survivin expression correlated with the OS of NSCLC patients significant (RR 1.88, 95% CI 1.31-2.70, P=0.0006). Data of seven studies were combined to demonstrate that the level of survivin correlated with the OS of NSCLC patients who had received radical surgeries (RR 1.79, 95% CI 1.45-2.20, P<0.00001). Data from three studies were combined to find that the level of nuclear survivin did not have impact on OS of NSCLC patients (RR 1.58, 95% CI 0.87-2.85, P=0.13). Positive-survivin expression might be a prognostic factor for NSCLC patients, nuclear survivin positivity could not work as a prognostic factor for NSCLC patients based on current clinical data. Larger clinical trails with widely accepted assessment methods are necessary to define the precise prognostic significance for survivin in NSCLC patients.
生存素对非小细胞肺癌（NSCLC）患者生存的预后价值仍存在争议。作者进行了文献荟萃分析以阐明其影响。通过电子检索确定已发表的研究，以便汇总现有的生存结果。要符合条件，一项研究必须涉及NSCLC患者原发部位的生存素评估，并根据生存素表达分析生存情况。有10项符合条件的研究，其中8项研究的数据采用非定位特异性免疫组织化学（IHC）定义系统、原位杂交（ISH）和逆转录聚合酶链反应（RT-PCR）相结合的方法，以呈现生存素对NSCLC患者总生存期（OS）的影响。生存素表达水平与NSCLC患者的OS显著相关（风险比1.88，95%置信区间1.31 - 2.70，P = 0.0006）。合并7项研究的数据表明，生存素水平与接受根治性手术的NSCLC患者的OS相关（风险比1.79，95%置信区间1.45 - 2.20，P < 0.00001）。合并3项研究的数据发现，核生存素水平对NSCLC患者的OS没有影响（风险比1.58，95%置信区间0.87 - 2.85，P = 0.13）。生存素阳性表达可能是NSCLC患者的一个预后因素，基于目前的临床数据，核生存素阳性不能作为NSCLC患者的预后因素。需要采用广泛接受的评估方法进行更大规模的临床试验，以确定生存素在NSCLC患者中的确切预后意义。
