Bu Qingting, He Hairong, Fan Di, Lyu Jun, Pan Zhenyu, You Haisheng
Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China; Department of Genetics, Northwest Women's and Children's Hospital, Xi'an, 710061, China.
Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Pathol Res Pract. 2018 Nov;214(11):1772-1777. doi: 10.1016/j.prp.2018.08.010. Epub 2018 Aug 17.
Wilms' tumor (WT) is the most common pediatric renal tumor. Despite its high survival rate, the potential prognostic factors should further be studied to reduce the intensity of the treatment. A few studies have found LOH of 16q is associated with worse survival in patients with WT, but it is still contradictory. This study aimed to performed a meta-analysis to clarify this.
Databases including the Wanfang, PubMed, Chinese National Knowledge Infrastructure, Embase, and Cochrane Library databases were searched July 2018. The meta-analysis was done using Stata (version 14.0). Publication bias was evaluated by funnel plots, Begg's test, and Egger's test. The trim-and-fill method was applied if significant publication bias existed. Sensitivity analysis was performed to evaluate the stability of the results.
This meta-analysis identified 9 cohort studies encompassing 3266 cases. The pooled relative risk when comparing LOH of 16q groups with control groups was 2.22 [95% confidence interval (CI) = 1.64-3.00, P < 0.001], and the pooled hazard ratio was 1.92 (95%CI = 1.32-2.80, P = 0.001). The results were stable after correcting for publication bias and performing a leave-one-out sensitivity analysis.
This meta-analysis indicated that LOH of 16q was significantly associated with worse survival in WT. Further studies need to identify this conclusion because the overall quality of the included studies is not high, investigate the impact of LOH of 16q on the survival of WT patients in different subgroups and identify better treatments for WT patients with LOH of 16q in order to lengthen their survival.
肾母细胞瘤(WT)是最常见的小儿肾肿瘤。尽管其生存率较高,但仍需进一步研究潜在的预后因素以降低治疗强度。一些研究发现16号染色体长臂杂合性缺失(LOH of 16q)与WT患者较差的生存率相关,但结果仍存在矛盾。本研究旨在进行一项荟萃分析以阐明这一问题。
于2018年7月检索万方、PubMed、中国知网、Embase和Cochrane图书馆数据库。使用Stata(版本14.0)进行荟萃分析。通过漏斗图、Begg检验和Egger检验评估发表偏倚。若存在显著发表偏倚,则应用修剪填充法。进行敏感性分析以评估结果的稳定性。
该荟萃分析纳入了9项队列研究,共3266例病例。比较16q LOH组与对照组时,合并相对风险为2.22 [95%置信区间(CI)=1.64 - 3.00,P < 0.001],合并风险比为1.92(95%CI = 1.32 - 2.80,P = 0.001)。在校正发表偏倚并进行逐一剔除敏感性分析后,结果稳定。
该荟萃分析表明,16q LOH与WT患者较差的生存率显著相关。由于纳入研究的总体质量不高,需要进一步研究以验证这一结论,调查16q LOH对不同亚组WT患者生存的影响,并确定针对16q LOH的WT患者的更好治疗方法,以延长其生存期。