Zhang Shi-Ming, Zhu Qing-Ge, Ding Xiao-Xiao, Lin Song, Zhao Jing, Guan Lei, Li Ting, He Bing, Zhang Hu-Qin
The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an JiaoTong University, Xi'an, 710049, China,
Cancer Manag Res. 2018 Sep 10;10:3393-3404. doi: 10.2147/CMAR.S167578. eCollection 2018.
The prognostic value of and mutations in resected non-small cell lung cancer (NSCLC) has been reported. However, conflicting results were reported in these studies. The effect of mutations in these two genes in resected NSCLC remains controversial.
We searched Internet databases for studies reporting disease-free survival (DFS) and overall survival (OS) in resected NSCLC patients with or mutations. A meta-analysis calculating the pooled hazard ratio (HR) for DFS and OS was used to measure the association of or mutations with the prognosis of patients after surgery.
A total of 9,635 patients from 32 studies were included in this analysis. The combined HR for mutations on DFS was 0.77 (95% CI 0.66-0.90, =0.001) and on OS was 0.72 (95% CI 0.66-0.80, <0.00001). In addition, the combined HR for mutations on DFS was 1.5 (95% CI 1.15-1.96, =0.002) and on OS was 1.49 (95% CI 1.28-1.73, <0.00001). Sensitivity analysis, subgroup analysis, and bias analysis proved the stability of the results.
The analysis showed that mutations were significantly associated with DFS and OS. These findings indicated that surgically treated NSCLC patients with mutations were inclined to exhibit a prolonged DFS and OS. In addition, the results indicated that mutations predicted worse DFS and OS in patients with resected NSCLC.
已报道了切除的非小细胞肺癌（NSCLC）中 和 突变的预后价值。然而，这些研究报告的结果相互矛盾。这两个基因的突变在切除的NSCLC中的作用仍存在争议。
我们在互联网数据库中搜索了报告有 或 突变的切除NSCLC患者的无病生存期（DFS）和总生存期（OS）的研究。使用计算DFS和OS合并风险比（HR）的荟萃分析来衡量 或 突变与手术后患者预后的关联。
本分析共纳入了来自32项研究的9635例患者。 突变对DFS的合并HR为0.77（95%CI 0.66 - 0.90， =0.001），对OS的合并HR为0.72（95%CI 0.66 - 0.80，<0.00001）。此外， 突变对DFS的合并HR为1.5（95%CI 1.15 - 1.96， =0.002），对OS的合并HR为1.49（95%CI 1.28 - 1.73，<0.00001）。敏感性分析、亚组分析和偏倚分析证实了结果的稳定性。
分析表明 突变与DFS和OS显著相关。这些发现表明，接受手术治疗的有 突变的NSCLC患者倾向于表现出更长的DFS和OS。此外，结果表明 突变预示着切除的NSCLC患者的DFS和OS更差。
