Han Feng, Hu Rong, Yang Hua, Liu Jian, Sui Jianmei, Xiang Xin, Wang Fan, Chu Liangzhao, Song Shibin
Department of Neurosurgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, People's Republic of China.
Department of Histology and Embryology, College of Basic Medical Sciences, Guizhou Medical University, Guiyang, Guizhou, People's Republic of China.
Onco Targets Ther. 2016 Jun 13;9:3485-92. doi: 10.2147/OTT.S99942. eCollection 2016.
We conducted this meta-analysis based on eligible trials to investigate the relationship between phosphatase and tensin homolog (PTEN) genetic mutation and glioma patients' survival.
PubMed, Web of Science, and EMBASE were searched for eligible studies regarding the relationship between PTEN genetic mutation and glioma patients' survival. The primary outcome was the overall survival of glioma patient with or without PTEN genetic mutation, and second outcome was prognostic factors for the survival of glioma patient. A fixed-effects or random-effects model was used to pool the estimates according to the heterogeneity among the included studies.
Nine cohort studies, involving 1,173 patients, were included in this meta-analysis. Pooled results suggested that glioma patients with PTEN genetic mutation had a significant shorter overall survival than those without PTEN genetic mutation (hazard ratio [HR] =2.23, 95% confidence interval [CI]: 1.35, 3.67; P=0.002). Furthermore, subgroup analysis indicated that this association was only observed in American patients (HR =2.19, 95% CI: 1.23, 3.89; P=0.008), but not in Chinese patients (HR =1.44, 95% CI: 0.29, 7.26; P=0.657). Histopathological grade (HR =1.42, 95% CI: 0.07, 28.41; P=0.818), age (HR =0.94, 95% CI: 0.43, 2.04; P=0.877), and sex (HR =1.28, 95% CI: 0.55, 2.98; P=0.564) were not significant prognostic factors for the survival of patients with glioma.
Current evidence indicates that PTEN genetic mutation is associated with poor prognosis in glioma patients. However, this finding is derived from data in observational studies, potentially subject to selection bias, and hence well conducted, high-quality randomized controlled trials are warranted.
我们基于符合条件的试验进行了这项荟萃分析,以研究磷酸酶和张力蛋白同源物(PTEN)基因突变与胶质瘤患者生存之间的关系。
检索了PubMed、Web of Science和EMBASE,以查找有关PTEN基因突变与胶质瘤患者生存关系的符合条件的研究。主要结局是有或无PTEN基因突变的胶质瘤患者的总生存期,次要结局是胶质瘤患者生存的预后因素。根据纳入研究之间的异质性,使用固定效应或随机效应模型汇总估计值。
这项荟萃分析纳入了9项队列研究,涉及1173例患者。汇总结果表明,有PTEN基因突变的胶质瘤患者的总生存期明显短于无PTEN基因突变的患者(风险比[HR]=2.23,95%置信区间[CI]:1.35,3.67;P=0.002)。此外,亚组分析表明,这种关联仅在美国患者中观察到(HR=2.19,95%CI:1.23,3.89;P=0.008),而在中国患者中未观察到(HR=1.44,95%CI:0.29,7.26;P=0.657)。组织病理学分级(HR=1.42,95%CI:0.07,28.41;P=0.818)、年龄(HR=0.94,95%CI:0.43,2.04;P=0.877)和性别(HR=1.28,95%CI:0.55,2.98;P=0.564)不是胶质瘤患者生存的显著预后因素。
当前证据表明,PTEN基因突变与胶质瘤患者的预后不良有关。然而,这一发现来自观察性研究的数据,可能存在选择偏倚,因此需要开展良好的、高质量的随机对照试验。