Wang Lei, Xin Fuli, Lin Nanping, Wang Yingchao, Liu Xiaolong, Liu Jingfeng
Mengchao Hepatobiliary Hospital of Fujian Medical University, The United Innovation of Mengchao Hepatobiliary Technology Key Laboratory of Fujian Province, Fuzhou, Fujian, PR China.
Medicine (Baltimore). 2018 Dec;97(52):e13786. doi: 10.1097/MD.0000000000013786.
Metallothioneins (MTs) were reported to be associated with many kinds of tumors' prognosis, although MTs expression varied greatly among tumors. To assess the prognostic value of Metallothioneins (MTs) in different kinds of tumors, comprehensive literature search was conducted to perform a meta-analysis.
Eligible studies were identified by PubMed, MEDLINE, Web of Science (WOS), the Cochrane Library of Systematic Reviews, EMBASE, China National Knowledge Infrastructure (CNKI), WANFANG database and SinoMed database up to December 2017, which was designed to assess the prognostic value of MTs in different kinds of tumors. The main endpoint events were overall survival (OS) and disease-free survival (DFS). Hazard ratios (HRs) and its variance were retrieved from the original studies directly or calculated using Engauge Digitizer version 4.1. Random or fixed effects model meta-analysis was employed depending on the heterogeneity. Publication bias was evaluated by funnel plots, Begg and Egger tests.
A total of 22 studies were enrolled in this meta-analysis, including 2843 tumor tissues (1517 were MTs negative/low, and 1326 were MTs high). Results showed that there was significant association between MTs expression and tumors' OS (HR = 1.60; 95%CI 1.34∼1.92, P < .00001). Subgroup analysis showed that high level of MTs expression was associated with prolonged OS in liver cancer (HR = 0.65, 95%CI 0.48∼0.89, P = .007), but it was on the contrary in the tumor of ovary (HR = 1.47, 95%CI 1.01∼2.14, P = .04), bladder (HR = 1.71, 95%CI 1.21∼2.42, P = .002), intestine (HR = 3.13, 95%CI 1.97∼4.97, P < .00001), kidney (HR = 3.31, 95%CI 1.61∼6.79, P = .001). However, there was no significant association between MTs expression and OS in breast (HR = 1.02, 95%CI 0.69∼1.51, P = .93).
MTs could be taken as a potential prognostic biomarker for tumors, and uniqueness of MTs prognostic value in liver cancer deserved further study.
金属硫蛋白（MTs）据报道与多种肿瘤的预后相关，尽管MTs在不同肿瘤中的表达差异很大。为评估金属硫蛋白（MTs）在不同类型肿瘤中的预后价值，进行了全面的文献检索以开展一项荟萃分析。
截至2017年12月，通过PubMed、MEDLINE、科学引文索引（WOS）、Cochrane系统评价图书馆、EMBASE、中国知网（CNKI）、万方数据库和中国生物医学文献数据库（SinoMed）识别符合条件的研究，这些研究旨在评估MTs在不同类型肿瘤中的预后价值。主要终点事件为总生存期（OS）和无病生存期（DFS）。风险比（HRs）及其方差直接从原始研究中获取或使用Engauge Digitizer 4.1版本进行计算。根据异质性采用随机或固定效应模型荟萃分析。通过漏斗图、Begg检验和Egger检验评估发表偏倚。
本荟萃分析共纳入22项研究，包括2843个肿瘤组织（1517个MTs阴性/低表达，1326个MTs高表达）。结果显示，MTs表达与肿瘤的OS之间存在显著关联（HR = 1.60；95%CI 1.34～1.92，P <.00001）。亚组分析显示，MTs高表达与肝癌患者OS延长相关（HR = 0.65，95%CI 0.48～0.89，P =.007），但在卵巢癌（HR = 1.47，95%CI 1.01～2.14，P =.04）、膀胱癌（HR = 1.71，95%CI 1.21～2.42，P =.002）、肠癌（HR = 3.13，95%CI 1.97～4.97，P <.00001）、肾癌（HR = 3.31，95%CI 1.61～6.79，P =.001）中情况相反。然而，MTs表达与乳腺癌的OS之间无显著关联（HR = 1.02，95%CI 0.69～1.51，P =.93）。
MTs可作为肿瘤潜在的预后生物标志物，MTs在肝癌中预后价值的独特性值得进一步研究。
