Li Chao, Zuo Didi, Yin Libin, Lin Yuyang, Li Chenguang, Liu Tao, Wang Lei
Department of Colorectal and Anal Surgery, The First Hospital of Jilin University, Changchun, China.
Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
Gastroenterol Res Pract. 2018 Jun 5;2018:6986870. doi: 10.1155/2018/6986870. eCollection 2018.
The reliability of MUC2 as a prognostic marker in colorectal cancer (CRC) is controversial. This study evaluated the association between MUC2 expression levels in CRC tissues and prognosis.
The PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc (CBMdisc), Wanfang Database, and China National Knowledge Infrastructure (CNKI) databases were searched to identify studies exploring the relationship between MUC2 expression in CRC tissues and overall survival (OS). Pooled hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were used to evaluate the associations between MUC2 expression levels and prognosis and MUC2 expression levels and CRC clinicopathological characteristics, respectively.
The meta-analysis included 11 studies (2619 patients). Low MUC2 expression level was significantly associated with poor OS (HR, 1.67; 95% CI, 1.43-1.94; < 0.00001) and disease-free survival (DFS)/recurrence-free survival (RFS) (HR, 1.60; 95% CI, 1.21-2.12; = 0.001) in patients with CRC. Low MUC2 expression level was associated with advanced TNM stage (RR, 1.42; 95% CI, 1.26-1.60; < 0.00001), lymph node metastasis (RR, 1.41; 95% CI, 1.25-1.60; < 0.00001), lymphatic invasion (RR,1.64; 95% CI, 1.26-2.12; = 0.0002), rectal tumor site (RR, 1.26; 95% CI, 1.09-1.46; = 0.001), and large tumor size (RR,1.32; 95% CI, 1.02-1.70; = 0.03). There were no associations between low MUC2 expression level and gender, histological grade, depth of invasion, and distant metastasis.
The low levels of MUC2 in CRC tissues are poor prognostic factor independent of stage or other well-recognized markers of later-stage disease. Large well-designed cohort studies are required to validate MUC2 as a biomarker for poor prognosis in CRC.
MUC2作为结直肠癌（CRC）预后标志物的可靠性存在争议。本研究评估了CRC组织中MUC2表达水平与预后之间的关联。
检索PubMed、Web of Science、Embase、Cochrane图书馆、中国生物医学文献数据库（CBMdisc）、万方数据库和中国知网（CNKI）数据库，以识别探索CRC组织中MUC2表达与总生存期（OS）之间关系的研究。采用合并风险比（HRs）和风险比（RRs）及95%置信区间（CIs）分别评估MUC2表达水平与预后以及MUC2表达水平与CRC临床病理特征之间的关联。
荟萃分析纳入了11项研究（2619例患者）。CRC患者中，低MUC2表达水平与较差的OS（HR，1.67；95%CI，1.43 - 1.94；P < 0.00001）及无病生存期（DFS）/无复发生存期（RFS）（HR，1.60；95%CI，1.21 - 2.12；P = 0.001）显著相关。低MUC2表达水平与晚期TNM分期（RR，1.42；95%CI，1.26 - 1.60；P < 0.00001）、淋巴结转移（RR，1.41；95%CI，1.25 - 1.60；P < 0.00001）、淋巴管浸润（RR，1.64；95%CI，1.26 - 2.12；P = 0.0002）、直肠肿瘤部位（RR，1.26；95%CI，1.09 - 1.46；P = 0.001）及肿瘤体积大（RR，1.32；95%CI，1.02 - 1.70；P = 0.03）相关。低MUC2表达水平与性别、组织学分级、浸润深度及远处转移之间无关联。
CRC组织中低水平的MUC2是独立于分期或其他公认的晚期疾病标志物的不良预后因素。需要开展大规模设计良好的队列研究来验证MUC2作为CRC不良预后生物标志物的作用。
