Hirbod-Mobarakeh Armin, Mirghorbani Masoud, Hajiju Fatemeh, Marvi Mahnaz, Bashiri Kiandokht, Rezaei Nima
Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Border of Immune Tolerance Education and Research Network (BITERN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
J Gastroenterol Hepatol. 2016 Jul;31(7):1246-56. doi: 10.1111/jgh.13284.
Gastrointestinal (GI) cancers are a heterogeneous group of cancers originating from the digestive system. Considering key roles of myeloid-derived suppressor cells (MDSCs) in the immunosuppression network, levels of MDSCs in patients with cancer are assumed to be of prognostic and predictive value. In this systematic review, we aimed to evaluate the clinical relevancy of MDSCs and their relationship with clinical features and prognosis of GI malignancies in patients with GI cancers.
We searched Medline, Scopus, DART, OpenGrey, and ProQuest without applying any language filter up to 1 August 2015. Two of the authors independently reviewed search results for irrelevant and duplicate studies and extracted data from studies. We used tabulation to synthesize the findings of the studies and transformed data into a common rubric and calculated a weighted treatment effect across studies using Review Manager.
We found 1238 references in five databases, and after exclusion of irrelevant and duplicate studies, 17 studies with a total number of 1115 patients with GI cancers were included. A meta-analysis of three studies showed associations of high MDSC levels with higher mortality during follow-up periods (hazard ratio = 3.35; 95% confidence interval = 1.46-7.68, P = 0.0004). A meta-analysis of four studies showed that patients with higher levels of MDSC had higher odds of having an advanced cancer (odds ratio = 2.64; 95% confidence interval = 1.53-4.53; P = 0.0004). There were also significant associations between MDSC levels and relapse, tumor progression, lymph node involvement, and metastasis.
In conclusion, results of this systematic review based on the available literature suggest that MDSC levels are of clinical relevancy and prognostic and predictive value.
胃肠道（GI）癌症是一组起源于消化系统的异质性癌症。鉴于髓系来源的抑制细胞（MDSCs）在免疫抑制网络中的关键作用，癌症患者体内MDSCs的水平被认为具有预后和预测价值。在本系统评价中，我们旨在评估MDSCs的临床相关性及其与胃肠道癌症患者胃肠道恶性肿瘤的临床特征和预后的关系。
我们检索了Medline、Scopus、DART、OpenGrey和ProQuest，截至2015年8月1日未应用任何语言过滤器。两位作者独立审查检索结果，排除不相关和重复的研究，并从研究中提取数据。我们使用列表法综合研究结果，将数据转化为通用的类别，并使用Review Manager计算各研究的加权治疗效果。
我们在五个数据库中找到了1238篇参考文献，排除不相关和重复的研究后，纳入了17项研究，共有1115例胃肠道癌症患者。三项研究的荟萃分析显示，MDSC水平高与随访期间较高的死亡率相关（风险比=3.35；95%置信区间=1.46-7.68，P=0.0004）。四项研究的荟萃分析表明，MDSC水平较高的患者患晚期癌症的几率更高（优势比=2.64；95%置信区间=1.53-4.53；P=0.0004）。MDSC水平与复发、肿瘤进展、淋巴结受累和转移之间也存在显著关联。
总之，基于现有文献的本系统评价结果表明，MDSC水平具有临床相关性以及预后和预测价值。
