Zhang Jianzhong, Miao Chenkui, Xu Aiming, Zhao Kai, Qin Zhiqiang, Li Xiao, Liang Chao, Hua Yibo, Chen Wei, Zhang Chao, Liu Yiyang, Su Shifeng, Wang Zengjun, Liu Bianjiang
State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing. 210029, China.
PLoS One. 2016 Aug 17;11(8):e0161150. doi: 10.1371/journal.pone.0161150. eCollection 2016.
Secretory clusterin (sCLU) is a potential prognostic tumour biomarker, but results of different sCLU studies are inconsistent. We conducted this meta-analysis to evaluate the precise predictive value of sCLU. Qualified studies were identified by performing online searches in PubMed, EMBASE, and Web of Science. The selected articles were divided into three groups based on scoring method for clusterin detection. Pooled hazard ratios (HRs) with 95% confidence interval (CI) for patient survival and disease recurrence were calculated to determine the correlation between sCLU expression and cancer prognosis. Heterogeneity was assessed using I2 statistics, and specific heterogeneity in different groups was analysed. Elevated sCLU was significantly associated with recurrence-free survival in groups 1 and 3 (group 1: pooled HR = 1.35, 95% CI = 1.01 to 1.79; group 3: pooled HR = 1.80, 95% CI = 1.22 to 2.65). However, clusterin expression was not associated with overall survival in all three groups. Results showed that only the heterogeneity of group 2 was very strong (p = 0.013, I2 = 76.3%), in which the specimens were scored through sCLU staining intensity only. sCLU is a potential biomarker for tumour prognosis, and IHC methods can be more standardised if both intensity and staining proportion are considered.
分泌型聚集素（sCLU）是一种潜在的肿瘤预后生物标志物，但不同的sCLU研究结果并不一致。我们进行了这项荟萃分析以评估sCLU的精确预测价值。通过在PubMed、EMBASE和Web of Science上进行在线搜索来识别合格的研究。根据聚集素检测的评分方法，将所选文章分为三组。计算患者生存和疾病复发的合并风险比（HRs）及其95%置信区间（CI），以确定sCLU表达与癌症预后之间的相关性。使用I2统计量评估异质性，并分析不同组中的特定异质性。在第1组和第3组中，sCLU升高与无复发生存显著相关（第1组：合并HR = 1.35，95% CI = 1.01至1.79；第3组：合并HR = 1.80，95% CI = 1.22至2.65）。然而，在所有三组中，聚集素表达与总生存均无关联。结果显示，只有第2组的异质性非常强（p = 0.013，I2 = 76.3%），该组标本仅通过sCLU染色强度进行评分。sCLU是一种潜在的肿瘤预后生物标志物，如果同时考虑强度和染色比例，免疫组化方法可以更加标准化。
