人平衡核苷转运体1在接受吉西他滨为基础化疗的胰腺癌中的预后价值：一项荟萃分析
Prognostic value of human equilibrative nucleoside transporter1 in pancreatic cancer receiving gemcitabin-based chemotherapy: a meta-analysis.
作者信息
Liu Zhu-Qing, Han Ying-Chao, Zhang Xi, Chu Li, Fang Jue-Min, Zhao Hua-Xin, Chen Yi-Jing, Xu Qing
机构信息
Department of Medical Oncology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China.
Department of Spine Surgery, Shanghai East Hospital, Tongji University, School of Medicine, Shanghai, China.
出版信息
PLoS One. 2014 Jan 27;9(1):e87103. doi: 10.1371/journal.pone.0087103. eCollection 2014.
BACKGROUND
The potential prognostic value of human equilibrative nucleoside transporter1 in pancreatic cancer receiving gemcitabine-based chemotherapy is variably reported.
OBJECTIVE
The objective of this study was to conduct a systematic review of literature evaluating human equilibrative nucleoside transporter1 expression as a prognostic factor in pancreatic cancer receiving gemcitabine-based chemotherapy and to conduct a subsequent meta-analysis to quantify the overall prognostic effect.
METHODS
Related studies were identified and evaluated for quality through multiple search strategies. Only studies analyzing pancreatic cancer receiving gemcitabine-based chemotherapy were eligible for inclusion. Data were collected from studies comparing overall, disease-free and progression-free survival (OS, DFS and PFS) in patients with low human equilibrative nucleoside transporter1 levels and those having high levels. The hazard ratio (HR) and its 95% confidence interval (95%CI) were used to assess the strength of associations. Hazard ratios greater than 1 reflect adverse survival associated with low human equilibrative nucleoside transporter1 levels.
RESULTS
A total of 12 studies (n = 875) were involved in this meta-analysis (12 for OS, 5 for DFS, 3 for PFS). For overall and disease-free survival, the pooled HRs of human equilibrative nucleoside transporter1 were significant at 2.93 (95% confidence interval [95% CI], 2.37-3.64) and 2.67 (95% CI, 1.87-3.81), respectively. For progression-free survival, the pooled HR in higher human equilibrative nucleoside transporter1 expression in pancreatic cancer receiving gemcitabine-based chemotherapy was 2.76 (95% CI, 1.76-4.34). No evidence of significant heterogeneity or publication bias was seen in any of these studies.
CONCLUSION
These results support the case for a low human equilibrative nucleoside transporter1 level representing a significant and reproducible marker of adverse prognosis in pancreatic cancer receiving gemcitabine-based chemotherapy.
背景
关于人平衡核苷转运体1在接受吉西他滨为主化疗的胰腺癌中的潜在预后价值，相关报道不一。
目的
本研究旨在对评估人平衡核苷转运体1表达作为接受吉西他滨为主化疗的胰腺癌预后因素的文献进行系统综述，并随后进行荟萃分析以量化总体预后效应。
方法
通过多种检索策略识别相关研究并评估其质量。仅分析接受吉西他滨为主化疗的胰腺癌的研究符合纳入标准。从比较人平衡核苷转运体1水平低的患者和水平高的患者的总生存期、无病生存期和无进展生存期（OS、DFS和PFS）的研究中收集数据。风险比（HR）及其95%置信区间（95%CI）用于评估关联强度。大于1的风险比反映与人平衡核苷转运体1水平低相关的不良生存情况。
结果
本荟萃分析共纳入12项研究（n = 875）（12项关于OS，5项关于DFS，3项关于PFS）。对于总生存期和无病生存期，人平衡核苷转运体1的合并HR分别为2.93（95%置信区间[95%CI]，2.37 - 3.64）和2.67（95%CI，1.87 - 3.81），具有显著性。对于无进展生存期，在接受吉西他滨为主化疗的胰腺癌中，人平衡核苷转运体1表达较高时的合并HR为2.76（95%CI，1.76 - 4.34）。在这些研究中均未发现显著异质性或发表偏倚的证据。
结论
这些结果支持以下观点，即人平衡核苷转运体1水平低是接受吉西他滨为主化疗的胰腺癌不良预后的一个显著且可重复的标志物。
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