Department of Surgery, Yonsei University Health System, Seoul, Korea.
J Surg Oncol. 2014 Aug;110(2):129-35. doi: 10.1002/jso.23618. Epub 2014 Apr 15.
The relationship between survival in gastric cancer patients and the status of microsatellite instability (MSI) has not yet been established. The purpose of this meta-analysis was to obtain integrated and more precise data for the value of MSI as a prognostic marker in gastric cancer.
A comprehensive systematic review and meta-analysis were conducted using major electronic databases (PubMed, EMBASE, and the Cochrane Central) with keywords related to "microsatellite instability," "gastric cancer," and "prognosis."
Twenty-four studies with 5,438 participants (712 cases were MSI gastric cancer) were included for pooling risk estimates of MSI in gastric cancer. Seventeen studies reported overall survival. The pooled hazard ratio (HR) for overall survival of MSI vs. non-MSI was 0.72 (95%CI: 0.59-0.88, P = .001) in a random-effects model. In the sensitivity analysis, the result from the most recent study showed the most heterogeneity.
MSI gastric cancer was associated with good prognosis but there was heterogeneity in the recent studies. Changed epidemiology and effects of chemotherapy are potential causes of heterogeneity. Establishing a consensus for defining MSI in gastric cancer should be preferred for future studies.
胃癌患者的生存与微卫星不稳定性（MSI）状态之间的关系尚未确定。本荟萃分析的目的是获取关于 MSI 作为胃癌预后标志物的价值的综合和更精确的数据。
使用与“微卫星不稳定性”、“胃癌”和“预后”相关的关键字，对主要电子数据库（PubMed、EMBASE 和 Cochrane Central）进行全面的系统评价和荟萃分析。
纳入了 24 项研究，共 5438 名参与者（712 例为 MSI 胃癌），用于汇总 MSI 在胃癌中的风险估计。17 项研究报告了总生存率。在随机效应模型中，MSI 与非 MSI 相比的总生存率的合并危险比（HR）为 0.72（95%CI：0.59-0.88，P = .001）。在敏感性分析中，最近的研究结果显示出最大的异质性。
MSI 胃癌与良好的预后相关，但最近的研究存在异质性。改变的流行病学和化疗的影响可能是异质性的原因。为未来的研究建立一个定义胃癌 MSI 的共识应该是首选的。
