Yang Yanlong, Luo Xiuping, Yang Nuo, Feng Ronghao, Xian Lei
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
Department of Chemotherapy, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
PLoS One. 2014 Nov 6;9(11):e111651. doi: 10.1371/journal.pone.0111651. eCollection 2014.
Recently, the correlation between the efficacy of platinum-based chemotherapy and ERCC1 expression in patients with SCLC has attracted wide-spread attention, and a lot of investigations have been conducted, whereas conflicting results were presented. Therefore, we performed the present meta-analysis of eligible studies to derive a more precise evaluation of the association between ERCC1 expression and the clinical outcome in SCLC patients receiving platinum-based chemotherapy. A literature search for relevant studies was conducted in the electronic databases of PubMed, EMBASE and Web of Science. The inclusive criteria were SCLC patients treated by platinum-based chemotherapy, and evaluated the relationship between ERCC1 expression and the clinical outcomes [including overall response rate (ORR), overall survival (OS) or progression-free survival (PFS)]. Odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) was calculated to assess the risk. A total of nine studies including 1129 patients were included in final analysis. Our analysis indicated that positive/high ERCC1 expression was associated with unfavorable OS (HR = 1.18, 95%CI = 1.02-1.37) and PFS (HR = 1.46, 95%CI = 1.14-1.88). Subgroup analysis according to disease stage suggested the significant relationship was found in limited stage (LS-SCLC), but not in extensive stage (ES-SCLC). However, no significant association was found between ERCC1 expression and ORR. Our analysis suggested ERCC1 expression may be a prognostic factor in SCLC patients receiving platinum-based chemotherapy, especially for LS-SCLC.
近年来,小细胞肺癌(SCLC)患者中铂类化疗疗效与ERCC1表达之间的相关性引起了广泛关注,并且已经开展了大量研究,但结果相互矛盾。因此,我们对符合条件的研究进行了本次荟萃分析,以更精确地评估接受铂类化疗的SCLC患者中ERCC1表达与临床结局之间的关联。在PubMed、EMBASE和Web of Science电子数据库中检索相关研究。纳入标准为接受铂类化疗的SCLC患者,并评估ERCC1表达与临床结局[包括总缓解率(ORR)、总生存期(OS)或无进展生存期(PFS)]之间的关系。计算比值比(OR)或风险比(HR)及95%置信区间(CI)以评估风险。最终分析共纳入9项研究,包括1129例患者。我们的分析表明,ERCC1阳性/高表达与不良的OS(HR = 1.18,95%CI = 1.02 - 1.37)和PFS(HR = 1.46,95%CI = 1.14 - 1.88)相关。根据疾病分期进行的亚组分析表明,这种显著关系在局限期(LS - SCLC)中存在,但在广泛期(ES - SCLC)中不存在。然而,未发现ERCC1表达与ORR之间存在显著关联。我们的分析表明,ERCC1表达可能是接受铂类化疗的SCLC患者的一个预后因素,尤其是对于LS - SCLC患者。