Wang Jianhua, Shen Jiajia, Huang Chi, Cao Meng, Shen Lizong
Division of Gastrointestinal Surgery, Department of General Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
Department of General Surgery, Affiliated Hospital of Integrated Chinese and Western Medicine of Nanjing University of Chinese Medicine, Nanjing 210028, China.
J Cancer. 2019 May 26;10(10):2332-2341. doi: 10.7150/jca.30789. eCollection 2019.
Numerous studies have identified mutation as a predictive factor of anti-EGFR antibodies in colorectal cancer (CRC). However, the association between mutation and clinicopathological features remains unclear. Therefore, we aimed to conduct an updated and comprehensive meta-analysis to evaluate the above issues. We performed a systematic literature search from PubMed, Web of Science, Embase, and PMC database examining the association between mutation and clinicopathological features in CRC patients. Odds ratio with 95% confidence interval were used to estimate the effects of mutation on each clinicopathological parameter with fixed-effect model or random-effect model. Sixty-one studies published, including 32407 CRC patients from multiple countries, were included in the meta-analysis. The overall mutation rate was 11.38%, and mutation was positively related to high disease stage (OR=0.81; 95% CI=0.72-0.92; =0.001), high T stage (OR=0.51; 95% CI=0.40-0.65; <0.00001), proximal colon (OR=4.76; 95% CI=3.81-5.96; <0.00001) or right colon (OR=5.15; 95% CI=4.35-6.10, <0.00001) tumor location, poor tumor differentiation (OR=0.27; 95% CI=0.21-0.34; <0.00001), mucinous histology (OR=2.97; 95% CI=2.37-3.72; <0.00001), K-ras-wild type (OR=0.04; 95% CI=0.02-0.07; <0.00001), TP53-wild type (OR=0.50; 95% CI=0.31-0.78; =0.003), deficient DNA mismatch repair (OR=2.93; 95% CI=1.78-4.82; <0.00001), high microsatellite instability (OR=11.15; 95% CI=8.51-14.61; <0.00001) and high CpG island methylator phenotype (OR=0.04; 95% CI=0.03-0.08; <0.00001). Our updated meta-analysis demonstrated that mutation was related to poor prognosis of CRC and associated with the distinct molecular phenotypes.
众多研究已将[具体基因]突变确定为结直肠癌（CRC）中抗表皮生长因子受体（EGFR）抗体的预测因素。然而，[具体基因]突变与临床病理特征之间的关联仍不明确。因此，我们旨在进行一项更新的综合荟萃分析来评估上述问题。我们从PubMed、Web of Science、Embase和PMC数据库进行了系统的文献检索，以研究CRC患者中[具体基因]突变与临床病理特征之间的关联。采用95%置信区间的比值比，通过固定效应模型或随机效应模型来估计[具体基因]突变对每个临床病理参数的影响。纳入荟萃分析的有61项已发表的研究，包括来自多个国家的32407例CRC患者。总体[具体基因]突变率为11.38%，且[具体基因]突变与高疾病分期（比值比=0.81；95%置信区间=0.72 - 0.92；P=0.001）、高T分期（比值比=0.51；95%置信区间=0.40 - 0.65；P<0.00001）、近端结肠（比值比=4.76；95%置信区间=3.81 - 5.96；P<0.00001）或右结肠（比值比=5.15；95%置信区间=4.35 - 6.10，P<0.00001）肿瘤位置、肿瘤低分化（比值比=0.27；95%置信区间=0.21 - 0.34；P<0.00001）、黏液性组织学（比值比=2.97；95%置信区间=2.37 - 3.72；P<0.00001）、K-ras野生型（比值比=0.04；95%置信区间=0.02 - 0.07；P<0.00001）、TP53野生型（比值比=0.50；95%置信区间=0.31 - 0.78；P=0.003）、DNA错配修复缺陷（比值比=2.93；95%置信区间=1.78 - 4.82；P<0.00001）、高微卫星不稳定性（比值比=11.15；95%置信区间=8.51 - 14.61；P<0.00001）以及高CpG岛甲基化表型（比值比=0.04；95%置信区间=0.03 - 0.08；P<0.00001）呈正相关。我们更新的荟萃分析表明，[具体基因]突变与CRC的不良预后相关，并与不同的分子表型有关。
