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Cyclin D1 表达在肾细胞癌中的预后意义:系统评价和荟萃分析。

Prognostic Significance of Cyclin D1 Expression in Renal Cell Carcinoma: a Systematic Review and Meta-analysis.

机构信息

Department of Urology, Qilu Hospital of Shandong University, Wenhuaxi Road 44, Jinan, Shandong, 250012, People's Republic of China.

出版信息

Pathol Oncol Res. 2020 Jul;26(3):1401-1409. doi: 10.1007/s12253-019-00776-0. Epub 2019 Nov 20.

Abstract

Previous studies indicated that cyclin D1 shown the potential as a tumor biomarker. However, the prognostic value of cyclin D1 in renal cell carcinoma (RCC) remains controversial. This study investigated the correlation of cyclin D1 expression with the prognostic and clinicopathological features in RCC patients. We systematically searched the database of PubMed, Embase, Cochrane, and Web of Science updated on November 26, 2017. Eighteen studies with 2282 patients satisfied the inclusion criteria. Results demonstrated that cyclin D1 overexpression in RCC showed significant favorable prognostic impact on disease-free survival (DFS) (HR 0.57, 95% CI: 0.43-0.74) and disease-specific survival (DSS) (HR 0.59, 95% CI 0.41-0.85) without significant heterogeneity. In subgroup of clear cell RCC, the prognostic effect on DFS was robust and the pooled HR was 0.39 (95% CI: 0.27-0.57). However, no association between overall survival (OS) and cyclin D1 expression was observed. Stratified analysis in DFS studies by sample size, staining patterns race and metastasis status showed similar results. Otherwise, cyclin D1 overexpression predicted a reduced prevalence of high TNM stage (T3 + T4) (OR 0.63, 95% CI: 0.40-0.99), high-grade tumor (G3 + G4) (OR 0.51, 95% CI: 0.31-0.81) and large tumor size (OR 0.35, 95% CI: 0.19-0.62). Our meta-analysis indicated that cyclin D1 overexpression could predict the favorable prognosis in patients with RCC.

摘要

先前的研究表明,细胞周期蛋白 D1 具有作为肿瘤标志物的潜力。然而,细胞周期蛋白 D1 在肾细胞癌 (RCC) 中的预后价值仍存在争议。本研究探讨了细胞周期蛋白 D1 表达与 RCC 患者预后和临床病理特征的相关性。我们系统地检索了 PubMed、Embase、Cochrane 和 Web of Science 数据库,检索日期截至 2017 年 11 月 26 日。有 18 项研究,共 2282 例患者符合纳入标准。结果表明,RCC 中细胞周期蛋白 D1 的过度表达对无病生存 (DFS) (HR 0.57, 95%CI: 0.43-0.74) 和疾病特异性生存 (DSS) (HR 0.59, 95%CI: 0.41-0.85) 具有显著的有利预后影响,且无明显异质性。在透明细胞 RCC 亚组中,DFS 的预后作用较为显著,合并 HR 为 0.39 (95% CI: 0.27-0.57)。然而,细胞周期蛋白 D1 的表达与总生存 (OS) 之间无相关性。DFS 研究中按样本量、染色模式、种族和转移状态进行分层分析,结果相似。此外,细胞周期蛋白 D1 过度表达预示着较高的 TNM 分期 (T3+T4) (OR 0.63, 95% CI: 0.40-0.99)、高级别肿瘤 (G3+G4) (OR 0.51, 95% CI: 0.31-0.81) 和较大肿瘤大小 (OR 0.35, 95% CI: 0.19-0.62) 的发生率降低。本荟萃分析表明,细胞周期蛋白 D1 过度表达可预测 RCC 患者的良好预后。

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