Zheng Qiang, Chen Changyu, Guan Haiyang, Kang Weibiao, Yu Changjun
Department of Gastrointestinal Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of General Surgery, First Affiliated Hospital of Anhui Traditional Medical University, Hefei, China.
Oncotarget. 2017 Jul 11;8(28):46611-46623. doi: 10.18632/oncotarget.16679.
Gastrointestinal cancers (GICs) mainly including esophageal, gastric and colorectal cancer, are the most common cause of cancer-related death and lead into high mortality worldwide. We performed this systematic review and meta-analysis to elucidate relationship between multiple microRNAs (miRs) expression and survival of GIC patients.
We searched a wide range of database. Fixed-effects and random-effects models were used to calculate the pooled hazard ratio values of overall survival and disease free survival. In addition, funnel plots were used to qualitatively analyze the publication bias and verified by Begg's test while it seems asymmetry.
60 studies involving a total of 6225 patients (1271 with esophageal cancer, 3467 with gastric cancer and 1517 with colorectal cancer) were included in our meta-analysis. The pooled hazard ratio values of overall survival related to different miRs expression in esophageal, gastric, colorectal and gastrointestinal cancer were 2.10 (1.78-2.49), 2.02 (1.83-2.23), 2.54 (2.14-3.02) and 2.15 (1.99-2.31), respectively. We have identified a total of 59 miRs including 23 significantly up-regulated expression miRs (miR-214, miR-17, miR-20a, miR-200c, miR-107, miR-27a, etc.) and 36 significantly down-regulated expression miRs (miR-433, let-7g, miR-125a-5p, miR-760, miR-206, miR-26a, miR-200b, miR-185, etc.) correlated with poor prognosis in GIC patients. Moreover, 35 of them revealed mechanisms.
Overall, specific miRs are significantly associated with the prognosis of GIC patients and potentially eligible for the prediction of patients survival. It also provides a potential value for clinical decision-making development and may serve as a promising miR-based target therapy waiting for further elucidation.
胃肠道癌(GICs)主要包括食管癌、胃癌和结直肠癌,是癌症相关死亡的最常见原因,在全球范围内导致高死亡率。我们进行了这项系统评价和荟萃分析,以阐明多种微小RNA(miRs)表达与GIC患者生存率之间的关系。
我们检索了广泛的数据库。采用固定效应和随机效应模型计算总生存期和无病生存期的合并风险比。此外,漏斗图用于定性分析发表偏倚,当出现不对称时用Begg检验进行验证。
我们的荟萃分析纳入了60项研究,共6225例患者(1271例食管癌患者、3467例胃癌患者和1517例结直肠癌患者)。食管癌、胃癌、结直肠癌和胃肠道癌中与不同miRs表达相关的总生存期合并风险比值分别为2.10(1.78 - 2.49)、2.02(1.83 - 2.23)、2.54(2.14 - 3.02)和2.15(1.99 - 2.31)。我们总共鉴定出59种miRs,包括23种显著上调表达的miRs(miR - 214、miR - 17、miR - 20a、miR - 200c、miR - 107、miR - 27a等)和36种显著下调表达的miRs(miR - 433、let - 7g、miR - 125a - 5p、miR - 760、miR - 206、miR - 26a、miR - 200b、miR - 185等),这些miRs与GIC患者的不良预后相关。此外,其中35种miRs揭示了相关机制。
总体而言,特定的miRs与GIC患者的预后显著相关,并且有可能用于预测患者的生存期。它还为临床决策制定提供了潜在价值,并且可能成为一种有前景的基于miR的靶向治疗方法,有待进一步阐明。