PIK3CA改变与胃癌患者预后的关联：一项荟萃分析。
Association between PIK3CA alteration and prognosis of gastric cancer patients: a meta-analysis.
作者信息
Li Hua, Chen Shubo, Li Hui, Cui Jianxin, Gao Yunhe, Wu Dianchao, Luan Shangfeng, Qin Yan, Zhai Tongshan, Liu Dengxiang, Huo Zhibin
机构信息
Department of Surgical Oncology, Affiliated Xing Tai People Hospital of Hebei Medial University, Xingtai 054001, China.
Department of Surgical Urology, Affiliated Xing Tai People Hospital of Hebei Medial University, Xingtai 054001, China.
出版信息
Oncotarget. 2018 Jan 2;9(7):7651-7659. doi: 10.18632/oncotarget.23871. eCollection 2018 Jan 26.
BACKGROUND
Increasing evidence suggests that dysregulation of phosphatidylinositol-4, 5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) plays an important role in carcinogenesis. However, the relationship between PIK3CA expression and gastric cancer (GC) prognosis remains controversial.
METHODS
We searchedPubMed, Embase, Web of Science, and the Cochrane Library databases for relevant studies up to June 30, 2017. Primary outcomes were hazard ratio (HR), odds ratio (OR), and 95% confidence intervals (CI) for association with overall survival and clinicopathological features.
RESULTS
Eleven studies comprising 2481 GC patients were analyzed. Pooled analysis showed that PIK3CA upregulation was significantly associated with worse overall survival (HR = 1.79, 95% CI 1.42-2.27, < 0.001) at the protein (HR = 1.94, 95% CI 1.52-2.47, < 0.001) but not the gene (HR = 1.57, 95% CI 0.92-2.69, = 0.097) level. gene mutation did not correlate with overall survival (HR = 1.05, 95% CI 0.83-1.34, = 0.666) but was significantly associated with poor tumor differentiation (OR = 0.37, 95% CI 0.17-0.76, = 0.011).
CONCLUSION
High PIK3CA protein expression predicted poor prognosis in GC, whereas gene amplification or mutation did not. Moreover, mutation was an indicator of poorly differentiated tumors.
背景
越来越多的证据表明，磷脂酰肌醇-4,5-二磷酸3-激酶催化亚基α（PIK3CA）的失调在肿瘤发生中起重要作用。然而，PIK3CA表达与胃癌（GC）预后之间的关系仍存在争议。
方法
我们检索了截至2017年6月30日的PubMed、Embase、Web of Science和Cochrane图书馆数据库中的相关研究。主要结局指标为与总生存期及临床病理特征相关的风险比（HR）、比值比（OR）和95%置信区间（CI）。
结果
分析了11项包含2481例GC患者的研究。汇总分析显示，PIK3CA上调与蛋白质水平的较差总生存期显著相关（HR = 1.79，95% CI 1.42 - 2.27，< 0.001），而非基因水平（HR = 1.57，95% CI 0.92 - 2.69，= 0.097）。基因 突变与总生存期无关（HR = 1.05，95% CI 0.83 - 1.34，= 0.666），但与肿瘤低分化显著相关（OR = 0.37，95% CI 0.17 - 0.76，= 0.011）。
结论
高PIK3CA蛋白表达预示GC预后不良，而基因扩增或突变则不然。此外， 突变是肿瘤低分化的一个指标。
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