Li Yang, Wei Jun, Xu Chuanhui, Zhao Zhongxin, You Tiangeng
Department of General surgery, East Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Radiology, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China.
PLoS One. 2014 Apr 11;9(4):e94508. doi: 10.1371/journal.pone.0094508. eCollection 2014.
Cyclin D1 plays a vital role in cancer cell cycle progression and is overexpressed in many human cancers, including colorectal cancer (CRC). However, the prognostic value of cyclin D1 overexpression in colorectal cancer is conflicting and heterogeneous. We conducted a meta-analysis to more precisely evaluate its prognostic significance.
A comprehensive literature search for relevant studies published up to January 2014 was performed using PubMed, EMBASE, and ISI Web of Science. The pooled hazard ratio (HR) with 95% confidence intervals (CI) was used to estimate the effects.
22 studies with 4150 CRC patients were selected to evaluate the association between cyclin D1 and overall survival (OS), disease-free survival (DFS) and clinicopathological parameters. In a random-effects model, the results showed that cyclin D1 overexpression in CRC was significantly associated with both poor OS (HR = 0.73, 95% CI: 0.63-0.85, P<0.001) and DFS (HR = 0.60, 95% CI: 0.44-0.82, P = 0.001). Additionally, cyclin D1 overexpression was significantly associated with more relative older patients (≥ 60 years) (OR 0.62, 95% CI 0.44-0.89, P = 0.009), T3,4 tumor invasion (OR 0.70, 95% CI 0.57-0.85, P<0.001), N positive (OR 0.75, 95% CI 0.60-0.95, P = 0.016) and distant metastasis (OR 0.60, 95% CI 0.36-0.99, P = 0.047) of CRC.
The meta-analysis results indicated that cyclin D1 is an unfavorable prognostic factor for CRC. Cyclin D1 overexpression might be associated with poor clinical outcome and some clinicopathological factors such as age, T category, N category and distant metastasis in CRC patients.
细胞周期蛋白D1在癌细胞周期进程中起关键作用，且在包括结直肠癌（CRC）在内的多种人类癌症中过表达。然而，细胞周期蛋白D1过表达在结直肠癌中的预后价值存在矛盾且不统一。我们进行了一项荟萃分析，以更精确地评估其预后意义。
使用PubMed、EMBASE和ISI科学网对截至2014年1月发表的相关研究进行全面文献检索。采用合并风险比（HR）及95%置信区间（CI）来估计效应。
选取22项研究共4150例CRC患者，以评估细胞周期蛋白D1与总生存期（OS）、无病生存期（DFS）及临床病理参数之间的关联。在随机效应模型中，结果显示CRC中细胞周期蛋白D1过表达与较差的OS（HR = 0.73，95%CI：0.63 - 0.85，P<0.001）和DFS（HR = 0.60，95%CI：0.44 - 0.82，P = 0.001）均显著相关。此外，细胞周期蛋白D1过表达与相对年龄较大（≥60岁）的患者（OR 0.62，95%CI 0.44 - 0.89，P = 0.009）、T3,4期肿瘤浸润（OR 0.70，95%CI 0.57 - 0.85，P<0.001）、N阳性（OR 0.75，95%CI 0.60 - 0.95，P = 0.016）以及CRC的远处转移（OR 0.60，95%CI 0.36 - 0.99，P = 0.047）显著相关。
荟萃分析结果表明，细胞周期蛋白D1是CRC的不良预后因素。细胞周期蛋白D1过表达可能与CRC患者不良临床结局及一些临床病理因素如年龄、T分期、N分期和远处转移相关。
