胃癌中 DNA 非整倍体的预后价值：3449 例病例的荟萃分析。
Prognostic value of DNA aneuploidy in gastric cancer: a meta-analysis of 3449 cases.
机构信息
Department of Medical Oncology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230000, Anhui Province, China.
The Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230000, Anhui Province, China.
出版信息
BMC Cancer. 2019 Jul 2;19(1):650. doi: 10.1186/s12885-019-5869-9.
BACKGROUND
DNA aneuploidy has attracted growing interest in clinical practice. Nevertheless, its prognostic value in gastric cancer patients remains controversial. This meta-analysis aims to explore the impact of DNA ploidy status on the survival of gastric cancer patients.
METHODS
We used PubMed and Web of Science databases to retrieve relevant articles. The correlation between DNA aneuploidy and the clinicopathological features of gastric cancer, such as stage, depth of invasion (T), lymph node metastasis (N), distant metastasis (M), differentiation (G), tumor types (Lauren classification) and overall survival (OS) were evaluated. Hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were collected carefully from each article OS was presented with HRs. The relationships between DNA aneuploidy and each characteristic were analyzed using risk ratios (RR) and a 95% confidence interval (CI). Significance was established using P < 0.05. Funnel plot was conducted to detect the publication bias.
RESULTS
After careful selection, 25 studies involving 3449 cases were eligible for further analyses. Patients with DNA aneuploidy were considered at risk of more advanced stages (stage III-IV vs. stages I-II, RR = 1.23; 95% CI, 1.07 to 1.42; P = 0.003), lymph node metastasis (N+ vs. N-: RR = 1.43; 95% CI, 1.12 to 1.82, P = 0.004), and intestinal tumor type (intestinal vs. diffuse: RR = 1.45; 95% CI, 1.02 to 2.06; P = 0.04). And an adverse relation was observed between DNA aneuploidy and tumor differentiation. While no association was found between DNA aneuploidy and distant metastasis (P = 0.42) nor depth of tumor invasion (P = 0.86). Regarding overall survival, aneuploid tumors were associated with worse survival in all patients (P < 0.00001).
CONCLUSIONS
We found that DNA aneuploidy was an important predictor for gastric cancer patients, and should be used as a potential biomarker for further classification in gastric cancer.
背景
DNA 非整倍体在临床实践中引起了越来越多的关注。然而，其在胃癌患者中的预后价值仍存在争议。本荟萃分析旨在探讨 DNA 倍性状态对胃癌患者生存的影响。
方法
我们使用 PubMed 和 Web of Science 数据库检索相关文章。评估了 DNA 非整倍体与胃癌的临床病理特征之间的相关性，如分期、浸润深度（T）、淋巴结转移（N）、远处转移（M）、分化（G）、肿瘤类型（Lauren 分类）和总生存（OS）。仔细从每篇文章中收集 OS 相关的风险比（HRs）和相应的 95%置信区间（CIs）。使用风险比（RR）和 95%置信区间（CI）分析 DNA 非整倍体与每个特征之间的关系。使用 P<0.05 确定显著性。使用漏斗图检测发表偏倚。
结果
经过仔细筛选，共有 25 项研究涉及 3449 例患者符合进一步分析的条件。DNA 非整倍体患者被认为处于更晚期的风险（III-IV 期与 I-II 期，RR=1.23；95%CI，1.07 至 1.42；P=0.003），淋巴结转移（N+与 N-：RR=1.43；95%CI，1.12 至 1.82，P=0.004）和肠型肿瘤（肠型与弥漫型：RR=1.45；95%CI，1.02 至 2.06；P=0.04）。并且 DNA 非整倍体与肿瘤分化呈负相关。而 DNA 非整倍体与远处转移（P=0.42）或肿瘤浸润深度（P=0.86）之间无关联。关于总生存，所有患者的非整倍体肿瘤与较差的生存相关（P<0.00001）。
结论
我们发现 DNA 非整倍体是胃癌患者的一个重要预测因子，应该作为胃癌进一步分类的潜在生物标志物。
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