Chen Zhiqiang, Zhang Long, Zhu Qin, Wang Xiaowei, Wu Jindao, Wang Xuehao
Key Laboratory on Living Donor Liver Transplantation of Ministry of Health, Department of Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
J Gastroenterol Hepatol. 2017 Mar;32(3):567-576. doi: 10.1111/jgh.13624.
The role of octamer-binding transcription factor 4 (Oct4) has been implicated in the clinical prognosis of various kinds of digestive system cancers, but the results remain controversial. The purpose of this meta-analysis is to assess the potential role of Oct4 as a prognostic marker in digestive system tumors.
Relevant articles were retrieved from Pubmed, Web of Science, and Cochrane Library up to July 2016. The software Stata 12.0 was used to analyze the outcomes, including overall survival (OS), disease-free survival, recurrence-free survival, and clinicopathological characteristics.
A total of 13 eligible studies with 1538 patients were included. Elevated Oct4 expression was significantly associated with poor OS (pooled hazard ratio [HR] = 2.183, 95% confidence interval [CI]: 1.824-2.612), disease-free survival (pooled HR = 1.973, 95% CI: 1.538-2.532), and recurrence-free survival (pooled HR = 2.209, 95% CI: 1.461-3.338) of digestive system malignancies. Subgroup analyses showed that cancer type, sample size, study quality, and laboratory detection method did not alter the significant prognostic value of Oct4. Additionally, Oct4 expression was found to be an independent predictive factor for OS (HR = 2.068, 95% CI: 1.633-2.619). No significant association was found between Oct4 and clinicopathological features of digestive system malignancies.
This study provided evidence of Oct4 and/or its closely related homolog protein as a predictive factor for patients with digestive system cancers. More large-scale clinical studies on the prognostic value of Oct4 are warranted.
八聚体结合转录因子4（Oct4）的作用已被认为与各种消化系统癌症的临床预后有关，但结果仍存在争议。本荟萃分析的目的是评估Oct4作为消化系统肿瘤预后标志物的潜在作用。
截至2016年7月，从PubMed、科学网和考克兰图书馆检索相关文章。使用Stata 12.0软件分析结果，包括总生存期（OS）、无病生存期、无复发生存期和临床病理特征。
共纳入13项符合条件的研究，涉及1538例患者。Oct4表达升高与消化系统恶性肿瘤的不良OS（合并风险比[HR]=2.183，95%置信区间[CI]：1.824-2.612）、无病生存期（合并HR=1.973，95%CI：1.538-2.532）和无复发生存期（合并HR=2.209，95%CI：1.461-3.338）显著相关。亚组分析表明，癌症类型、样本量、研究质量和实验室检测方法并未改变Oct4的显著预后价值。此外，发现Oct4表达是OS的独立预测因素（HR=2.068，95%CI：1.633-2.619）。未发现Oct4与消化系统恶性肿瘤的临床病理特征之间存在显著关联。
本研究提供了Oct4和/或其密切相关的同源蛋白作为消化系统癌症患者预测因素的证据。有必要开展更多关于Oct4预后价值的大规模临床研究。
