ZAP-70 在慢性淋巴细胞白血病中的作用：一项荟萃分析。

ZAP-70 in chronic lymphocytic leukemia: A meta-analysis.

机构信息

Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan 430071, China.

出版信息

Clin Chim Acta. 2018 Aug;483:82-88. doi: 10.1016/j.cca.2018.04.026. Epub 2018 Apr 20.

DOI:10.1016/j.cca.2018.04.026

PMID:29680229

Abstract

BACKGROUND

Recent studies have reported that zeta-chain-associated protein kinase 70 (ZAP-70) expression plays a prognostic role in chronic lymphocytic leukemia (CLL). However, these results remain controversial. Thus, we performed a meta-analysis to clarify the prognostic value of ZAP-70 expression in CLL.

MATERIALS AND METHODS

Relevant studies were searched in PubMed, Embase, Cochrane library, and Web of Science up to January 2018. Clinicopathological features and prognostic data were extracted from the studies. We pooled estimates and 95% confidence intervals (CIs) and estimated the heterogeneity of studies using Mantel-Haenszel or DerSimonian and Laird method.

RESULTS

Twelve studies that included 1956 patients with CLL were eligible for inclusion. The pooled results revealed that increased ZAP-70 expression was significantly associated with poor overall survival (hazard ratio [HR] = 2.48, 95% CI: 1.72-3.59, P = 0.019, I = 53.0%) and event-free survival (HR = 4.17, 95% CI: 2.17-8.01, P = 0.014, I = 68.2%) in a random-effects model with significant heterogeneity. Clinicopathological analysis demonstrated that ZAP-70 expression was significantly associated with unmutated immunoglobulin heavy-chain genes, CD38 expression, serum β-2 microglobulin, and lymphocyte doubling time.

CONCLUSIONS

Our findings indicated that ZAP-70 was a strong prognostic biomarker for patients with CLL.

摘要

背景

最近的研究报告表明，ζ 链相关蛋白激酶 70（ZAP-70）表达在慢性淋巴细胞白血病（CLL）中具有预后作用。然而，这些结果仍存在争议。因此，我们进行了一项荟萃分析，以阐明 ZAP-70 表达在 CLL 中的预后价值。

材料和方法

检索了 PubMed、Embase、Cochrane 图书馆和 Web of Science 中截至 2018 年 1 月的相关研究。从研究中提取临床病理特征和预后数据。我们使用 Mantel-Haenszel 或 DerSimonian 和 Laird 方法汇总估计值和 95%置信区间（CI），并评估研究的异质性。

结果

共有 12 项包含 1956 例 CLL 患者的研究符合纳入标准。汇总结果显示，ZAP-70 表达增加与总生存期不良显著相关（风险比[HR] = 2.48，95%CI：1.72-3.59，P = 0.019，I² = 53.0%）和无事件生存期不良（HR = 4.17，95%CI：2.17-8.01，P = 0.014，I² = 68.2%），异质性显著。临床病理分析表明，ZAP-70 表达与未突变免疫球蛋白重链基因、CD38 表达、血清β-2 微球蛋白和淋巴细胞倍增时间显著相关。