Liu K L, Fan J H, Wu Jing
Clin Lab. 2017 May 1;63(5):871-880. doi: 10.7754/Clin.Lab.2017.170110.
Soluble uPAR (suPAR) is a soluble fraction of uPAR which is an important cell surface receptor. Recent evidence suggests that circulating suPAR levels are elevated in multiple malignancies and associated with prognosis of patients, although the results are not consistent. This study aimed to analyze the effect of suPAR on the prognosis in various carcinomas through a systematic review and meta-analysis.
Eligible studies were searched in PubMed and EMBASE. Data were extracted from studies investigating the relationship between circulating suPAR and survival in patients with cancers. A meta-analysis of the hazard ratio (HR) was then performed to evaluate the prognostic role of suPAR in various carcinomas. Pooled HRs of suPAR for overall survival (OS) were calculated to measure the effect of circulating suPAR level on prognosis.
After the literature search and systematic review, 12 articles regarding suPAR (I - III + II - III) including 2878 patients were included in a meta-analysis, which indicated a significantly poor OS in patients with high expression levels of circulating suPAR in subgroups of colorectal cancer (CRC), ovarian cancer, breast cancer, and prostate cancer (total HR 1.63, 95% CI 1.46 - 1.81) , and this effect is most obvious in patients with CRC (HR 1.67, 95% CI 1.47 - 1.89). No evidence of heterogeneity and publication bias was present.
Our results suggested that suPAR is a promising biomarker in the prediction of prognosis in patients with cancers. However, further studies are warranted to validate its clinical application and biological implication with tumor development.
可溶性尿激酶型纤溶酶原激活物受体（suPAR）是尿激酶型纤溶酶原激活物受体（uPAR）的可溶性部分，uPAR是一种重要的细胞表面受体。近期证据表明，多种恶性肿瘤患者的循环suPAR水平升高，且与患者预后相关，尽管结果并不一致。本研究旨在通过系统评价和荟萃分析，分析suPAR对各种癌症预后的影响。
在PubMed和EMBASE中检索符合条件的研究。从研究循环suPAR与癌症患者生存关系的研究中提取数据。然后进行风险比（HR）的荟萃分析，以评估suPAR在各种癌症中的预后作用。计算suPAR总体生存（OS）的合并HR，以衡量循环suPAR水平对预后的影响。
经过文献检索和系统评价，12篇关于suPAR（I - III + II - III）的文章（包括2878例患者）被纳入荟萃分析，结果表明，在结直肠癌（CRC）、卵巢癌、乳腺癌和前列腺癌亚组中，循环suPAR高表达患者的OS显著较差（总HR 1.63，95%CI 1.46 - 1.81），且这种影响在CRC患者中最为明显（HR 1.67，95%CI 1.47 - 1.89）。不存在异质性和发表偏倚的证据。
我们的结果表明，suPAR是预测癌症患者预后的一个有前景的生物标志物。然而，需要进一步研究来验证其临床应用以及与肿瘤发生发展的生物学意义。
