survivin 表达在结直肠癌患者中的预后价值：一项荟萃分析。

The prognostic value of survivin expression in patients with colorectal carcinoma: a meta-analysis.

机构信息

*Department of Oncology, The Sixth People's Hospital, Shanghai Jiao Tong University, No. 600, Yishan Road, Shanghai 200233, China.

出版信息

Jpn J Clin Oncol. 2013 Oct;43(10):988-95. doi: 10.1093/jjco/hyt103. Epub 2013 Jul 25.

DOI:10.1093/jjco/hyt103

PMID:23894202

Abstract

OBJECTIVE

The prognostic role of survivin in colorectal carcinoma remains controversial. This meta-analysis aimed to explore the association between survivin expression and survival outcomes in patients with colorectal carcinoma.

METHODS

A comprehensive literature search for relevant studies published up to April 2013 was performed using PubMed, MEDLINE and ISI Web of Science. Only articles in which survivin was detected by immunohistochemical staining were included. This meta-analysis was done using STATA and Review Manager.

RESULTS

A total of 1784 patients from 14 studies were included in the analysis. Our results showed that survivin overexpression in patients with colorectal carcinoma was significantly associated with poor overall survival (hazard ratio, 1.505; 95% confidence interval, 1.197-1.893; P = 0.000) and disease-free survival (hazard ratio, 2.323; 95% confidence interval, 1.687-3.199; P = 0.000). The results indicated that a significant relationship between survivin expression and overall survival was also exhibited in studies with an Asian country (hazard ratio, 1.684; 95% confidence interval, 1.477-1.921), patient number >100 (hazard ratio, 1.604; 95% confidence interval, 1.371-1.877), the cut-off level <50% (hazard ratio, 1.449; 95% confidence interval, 1.045-2.010), the percentage of survivin overexpression >50% (hazard ratio, 1.528; 95% confidence interval, 1.056-2.211) and the hazard ratio estimated (hazard ratio, 1.643; 95% confidence interval, 1.262-2.139). Moreover, upregulation of survivin was associated with stages (III/IV vs. I/II: odds ratio, 1.08; 95% confidence interval, 0.80-1.46), the depth of invasion (T3/T4 vs. T1/T2: odds ratio, 1.79; 95% confidence interval 0.67-4.74), lymph node metastasis (positive vs. negative: odds ratio, 1.49; 95% confidence interval, 0.99-2.26), distant metastasis (positive vs. negative: odds ratio, 2.37; 95% confidence interval, 0.99-5.72) and grade of differentiation (well/moderate vs. poor: odds ratio, 1.02; 95% confidence interval, 0.43-2.41), but without significance.

CONCLUSION

The present meta-analysis indicated that upregulation of survivin was associated with poor prognosis in patients with colorectal carcinoma.

摘要

目的

生存素在结直肠癌中的预后作用仍存在争议。本荟萃分析旨在探讨生存素表达与结直肠癌患者生存结局之间的关系。

方法

通过 PubMed、MEDLINE 和 ISI Web of Science 全面检索截至 2013 年 4 月发表的相关研究。仅纳入使用免疫组织化学染色检测生存素的文章。使用 STATA 和 Review Manager 进行荟萃分析。

结果

共纳入 14 项研究的 1784 例患者。结果显示，结直肠癌患者生存素过表达与总体生存率降低显著相关（风险比，1.505；95%置信区间，1.197-1.893；P = 0.000）和无病生存率降低显著相关（风险比，2.323；95%置信区间，1.687-3.199；P = 0.000）。结果表明，在具有亚洲国家的研究中（风险比，1.684；95%置信区间，1.477-1.921）、患者人数＞100 例（风险比，1.604；95%置信区间，1.371-1.877）、截断值＜50%（风险比，1.449；95%置信区间，1.045-2.010）、生存素过表达百分比＞50%（风险比，1.528；95%置信区间，1.056-2.211）和风险比估计值（风险比，1.643；95%置信区间，1.262-2.139）中，生存素表达与总体生存率之间也存在显著关系。此外，生存素的上调与分期（III/IV 期 vs. I/II 期：比值比，1.08；95%置信区间，0.80-1.46）、浸润深度（T3/T4 期 vs. T1/T2 期：比值比，1.79；95%置信区间，0.67-4.74）、淋巴结转移（阳性 vs. 阴性：比值比，1.49；95%置信区间，0.99-2.26）、远处转移（阳性 vs. 阴性：比值比，2.37；95%置信区间，0.99-5.72）和分化程度（高/中 vs. 低：比值比，1.02；95%置信区间，0.43-2.41）有关，但无统计学意义。