Qian Ying-Ying, Liu Xin-You, Pei Dong, Xu Jia-Li, Shen Hua, Chen Xiao-Feng, Liu Yi-Qian, Shen Li-Zong, Shu Yong-Qian
Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China E-mail :
Asian Pac J Cancer Prev. 2014;15(22):9699-706. doi: 10.7314/apjcp.2014.15.22.9699.
The predictive value of the xeroderma pigmentosum group D (XPD) Lys751Gln polymorphism regarding clinical outcomes of patients with colorectal cancer (CRC) receiving oxaliplatin-based chemotherapy has been evaluated in numerous published studies, but the results remain inconclusive. Therefore, we performed a meta-analysis to determine the precise role of the XPD Lys751Gln polymorphism in this clinical situation and optimize individual chemotherapy.
A multiple search strategy was used to identify eligible studies. Pooled odds ratios (ORs), generalized odds ratio (ORG) and their 95% confidence intervals (CIs) were used to estimate the objective response, while hazard ratios (HRs) with 95%CIs were used for progression-free survival (PFS) and overall survival (OS).
A total of 17 studies including 2,286 patients met the inclusion criteria. Overall, the XPD 751Gln allele was associated with a non-significant reduced objective response to oxaliplatin-based chemotherapy in all patients or in the Asian and Caucasian subgroups. However, poor PFS and OS of CRC patients treated with oxaliplatin-based regimens were significantly related to the XPD 751Gln allele in the dominant model (PFS: HR=2.10, 95%CI: 1.65-2.67; OS: HR=3.18, 95%CI: 1.57-6.47). On stratified analysis by ethnicity, these relationships were more pronounced in Asians (PFS: HR=2.49, 95%CI: 1.79-3.47; OS: HR=5.25, 95%CI: 3.46-7.94) than in Caucasians (PFS: HR=1.73, 95%CI: 1.22-2.46; OS: HR=1.78, 95%CI: 1.06-2.99).
The XPD Lys751Gln polymorphism may have prognostic value in patients with CRC undergoing oxaliplatin-based chemotherapy.
众多已发表的研究评估了着色性干皮病D组（XPD）Lys751Gln多态性对接受奥沙利铂化疗的结直肠癌（CRC）患者临床结局的预测价值，但结果仍无定论。因此，我们进行了一项荟萃分析，以确定XPD Lys751Gln多态性在这种临床情况下的确切作用，并优化个体化化疗。
采用多种检索策略来识别符合条件的研究。合并比值比（OR）、广义比值比（ORG）及其95%置信区间（CI）用于估计客观缓解率，而风险比（HR）及其95%CI用于无进展生存期（PFS）和总生存期（OS）。
共有17项研究（包括2286例患者）符合纳入标准。总体而言，XPD 751Gln等位基因与所有患者或亚洲及高加索亚组中对奥沙利铂化疗的客观缓解率非显著降低相关。然而，在显性模型中，接受奥沙利铂方案治疗的CRC患者的不良PFS和OS与XPD 751Gln等位基因显著相关（PFS：HR = 2.10，95%CI：1.65 - 2.67；OS：HR = 3.18，95%CI：1.57 - 6.47）。按种族进行分层分析时，这些关系在亚洲人中比在高加索人中更明显（PFS：HR = 2.49，95%CI：1.79 - 3.47；OS：HR = 5.25，95%CI：3.46 - 7.94）（PFS：HR = 1.73，95%CI：1.22 - 2.46；OS：HR = 1.78，95%CI：1.06 - 2.99）。
XPD Lys751Gln多态性可能对接受奥沙利铂化疗的CRC患者具有预后价值。
