Tan Li, Wu Yinying, Ma Xiaowei, Yan Yanli, Shao Shuai, Liu Jiaxin, Ma Hailin, Liu Rui, Chai Linyan, Ren Juan
Medical school, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
Pathol Oncol Res. 2019 Apr;25(2):791-799. doi: 10.1007/s12253-019-00598-0. Epub 2019 Feb 14.
Non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation have different clinicopathological characteristics compared with EGFR wild type NSCLC. A growing number of studies focused on the relevance between EGFR mutation status and brain metastases (BM) in NSCLC, but it remains controversial. Therefore, this study performed a comprehensive meta-analysis to untangle this issue. Several electronic databases including Pubmed, Embase, Web of science and Cochrane database were thoroughly searched. The odds ratio (OR) with 95% confidence interval (95%CI) was pooled to evaluate the relevance. Meta-regression analysis and subgroup analysis were conducted according to the heterogeneity. A total of 26 studies were identified finally in this meta-analysis. The overall OR was 1.58 (95%CI: 1.36-1.84), which indicated that EGFR mutation had a positive association with BM of NSCLC. The subgroup analysis resulted from eleven studies with lung adenocarcinoma revealed a higher possibility of BM in NSCLC with EGFR mutation compared with EGFR wild (p < 0.05). There was no significant difference in the risk of BM between NSCLC EGFR exon 19 mutation and exon 21 point mutation (p = 0.23). This meta-analysis suggests that EGFR mutation can be a risk factor for BM in NSCLC.
与表皮生长因子受体(EGFR)野生型非小细胞肺癌(NSCLC)相比,具有EGFR突变的NSCLC具有不同的临床病理特征。越来越多的研究关注NSCLC中EGFR突变状态与脑转移(BM)之间的相关性,但仍存在争议。因此,本研究进行了一项全面的荟萃分析来理清这个问题。对包括PubMed、Embase、科学网和Cochrane数据库在内的几个电子数据库进行了全面检索。汇总具有95%置信区间(95%CI)的比值比(OR)以评估相关性。根据异质性进行了Meta回归分析和亚组分析。在这项荟萃分析中最终共确定了26项研究。总体OR为1.58(95%CI:1.36 - 1.84),这表明EGFR突变与NSCLC的BM呈正相关。对11项肺腺癌研究进行的亚组分析显示,与EGFR野生型相比,具有EGFR突变的NSCLC发生BM的可能性更高(p < 0.05)。NSCLC的EGFR外显子19突变和外显子21点突变之间的BM风险没有显著差异(p = 0.23)。这项荟萃分析表明,EGFR突变可能是NSCLC发生BM的一个危险因素。