胆道癌化疗疗效的预后免疫组化生物标志物：系统评价和荟萃分析。

Prognostic immunohistochemical biomarkers of chemotherapy efficacy in biliary tract cancer: A systematic review and meta-analysis.

机构信息

Amsterdam UMC, University of Amsterdam, Dept. Medical Oncology, Cancer Center Amsterdam, Amsterdam, the Netherlands.

Amsterdam UMC, University of Amsterdam, Dept. Medical Oncology, Cancer Center Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Dept. Gastroenterology, Cancer Center Amsterdam, Amsterdam, the Netherlands.

出版信息

Crit Rev Oncol Hematol. 2019 Sep;141:82-94. doi: 10.1016/j.critrevonc.2019.06.001. Epub 2019 Jun 8.

DOI:10.1016/j.critrevonc.2019.06.001

PMID:31255992

Abstract

INTRODUCTION

Chemotherapy is the mainstay of systemic treatment of biliary tract cancer (BTC). However, the treatment response to chemotherapy varies between patients. Currently, no prognostic biomarkers for chemotherapy efficacy have been considered for use in clinical practice. A systematic review was conducted to evaluate the prognostic value of immunohistochemical biomarkers for chemotherapy in patients with resected as well as with advanced BTC.

METHOD

Medline and EMBASE databases were searched up to March 2017 for studies that evaluated biomarker expression by immunohistochemistry in resected or advanced BTC patients treated with chemotherapy. The primary endpoints were overall survival (OS) and disease or progression free survival (DFS or PFS).

RESULT

Twenty-six studies, including a total of 1348 patients and 26 different biomarkers, met the inclusion criteria and were included in this review. The most frequently studied prognostic biomarkers in BTC were the human Equilibrative Nucleoside Transporter 1 (hENT1), Ribonucleotide Reductase M1 (RRM1), and excision repair cross-complementation 1 (ERCC1). In the meta-analysis of patients treated with gemcitabine-based chemotherapy, high hENT1 expression was associated with longer OS (HR 0.43, 95% CI: 0.28 to 0.64) and DFS/PFS (HR 0.45, 95% CI: 0.33 to 0.61).

CONCLUSION

hENT1 is a promising prognostic biomarker for gemcitabine-based chemotherapy in resected as well as in advanced BTC and should be further validated for the selection of patients for chemotherapy.

摘要

简介

化疗是胆道癌（BTC）系统治疗的主要手段。然而，患者对化疗的反应存在差异。目前，尚无用于临床实践的化疗疗效预后生物标志物。本系统评价旨在评估免疫组织化学生物标志物在接受化疗的BTC 可切除和晚期患者中的预后价值。

方法

截至 2017 年 3 月，我们检索了 Medline 和 EMBASE 数据库，以评估接受化疗的 BTC 可切除或晚期患者中免疫组织化学标志物的表达。主要终点为总生存期（OS）和疾病或无进展生存期（DFS 或 PFS）。

结果

共纳入 26 项研究，总计 1348 例患者和 26 种不同的生物标志物。BTC 中最常研究的预后生物标志物是人类核苷转运蛋白 1（hENT1）、核苷酸还原酶 M1（RRM1）和切除修复交叉互补基因 1（ERCC1）。在接受吉西他滨为基础的化疗的患者的荟萃分析中，高 hENT1 表达与更长的 OS（HR 0.43，95%CI：0.28 至 0.64）和 DFS/PFS（HR 0.45，95%CI：0.33 至 0.61）相关。