病毒感染与神经胶质瘤：预后的荟萃分析。
Viral infection and glioma: a meta-analysis of prognosis.
机构信息
Department of neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No.119 West Nansihuan Road, Beijing, 100071, China.
出版信息
BMC Cancer. 2020 Jun 12;20(1):549. doi: 10.1186/s12885-020-06796-3.
BACKGROUND
Glioma is the most common primary brain tumor, occurring due to the carcinogenesis of glial cells in the brain and spinal cord. Many aspects of the mechanism of its tumorigenesis remain unknown. The relationship between viral infection and glioma is one of the most important research aspects in this field. Currently, there is a lack of systematic reviews and meta-analyses to evaluate the effect of viral infection on the prognosis of glioma patients. The purpose of this study was to evaluate the relationship between viral infection and the prognosis of glioma patients, aimed at evaluating the prognostic value of the detection of viral infection.
METHODS
Through careful and comprehensive retrieval of results from the PubMed, Embase, and Cochrane databases, eligible articles were selected strictly according to the inclusion and exclusion criteria. The regional sources, detection methods, detection indicators, patient survival, and other data from the samples in the papers were extracted, and the integrated analysis was conducted using Stata 15.1. We conducted a subgroup analysis of the relationship between the degree of infection and prognosis in cytomegalovirus (CMV) patients.
RESULTS
A total of 11 studies were included in the analysis. Among them, 7 studies involved the relationship between CMV infection and the prognosis of patients with glioma, 2 studies involved human papillomavirus (HPV), 2 studies involved human herpesvirus-6 (HHV-6), and one study involved simian virus 40 (SV40), woolly monkey sarcoma virus (WMSV) and human endogenous retrovirus K113 (HERV-K113). In the CMV study, the pooled Hazard ratio (HR) of Overall survival (OS) was 1.024 (CI: 0.698-1.501), with a P value of 0.905. The pooled HR of Progression free survival (PFS) was 1.067 (CI: 0.770-1.478), with a P value of 0.697. The pooled HR value of low-degree infection versus high-degree infection was 1.476 (CI: 0.799-2.727), with a P value of 0.213. In the HPV study, the pooled HR of OS was 1.467 (CI: 0.552-3.901), with a P value of 0.443.
CONCLUSION
CMV infection has no significant effect on the prognosis of glioma patients. Using the IEA as the detection index, the degree of CMV infection was found to have a significant impact on the prognosis of glioma patients; it was not found to possess a significant prognostic value after the integration of different indicators. Neither HPV nor HHV-6 infection has a significant effect on the prognosis of glioma patients. SV40 and WMSV infection are associated with poor prognosis in patients with low-grade glioma.
TRIAL REGISTRATION
This meta-analysis registered in https://www.crd.york.ac.uk/PROSPERO/, PROSPERO ID: CRD42019127648.
背景
脑胶质瘤是最常见的原发性脑肿瘤，发生于脑和脊髓的神经胶质细胞癌变。其肿瘤发生机制的很多方面仍不清楚。病毒感染与脑胶质瘤之间的关系是该领域最重要的研究方向之一。目前，缺乏系统评价和荟萃分析来评估病毒感染对脑胶质瘤患者预后的影响。本研究旨在评估病毒感染与脑胶质瘤患者预后之间的关系，旨在评估病毒感染检测的预后价值。
方法
通过仔细和全面地检索 PubMed、Embase 和 Cochrane 数据库的结果，根据纳入和排除标准严格选择符合条件的文章。从论文中的样本中提取区域来源、检测方法、检测指标、患者生存等数据，并使用 Stata 15.1 进行综合分析。我们对巨细胞病毒（CMV）患者感染程度与预后的关系进行了亚组分析。
结果
共纳入 11 项研究。其中，7 项研究涉及 CMV 感染与脑胶质瘤患者预后的关系，2 项研究涉及人乳头瘤病毒（HPV），2 项研究涉及人类疱疹病毒-6（HHV-6），1 项研究涉及猴病毒 40（SV40）、羊毛猴肉瘤病毒（WMSV）和人类内源性逆转录病毒 K113（HERV-K113）。在 CMV 研究中，总生存（OS）的合并风险比（HR）为 1.024（CI：0.698-1.501），P 值为 0.905。无进展生存（PFS）的合并 HR 为 1.067（CI：0.770-1.478），P 值为 0.697。低度感染与高度感染的合并 HR 值为 1.476（CI：0.799-2.727），P 值为 0.213。在 HPV 研究中，OS 的合并 HR 为 1.467（CI：0.552-3.901），P 值为 0.443。
结论
CMV 感染对脑胶质瘤患者的预后没有显著影响。使用 IEA 作为检测指标，发现 CMV 感染程度对脑胶质瘤患者的预后有显著影响；整合不同指标后，并未发现其具有显著的预后价值。HPV 和 HHV-6 感染均对脑胶质瘤患者的预后无显著影响。SV40 和 WMSV 感染与低级别胶质瘤患者的不良预后相关。
试验注册
本荟萃分析在 https://www.crd.york.ac.uk/PROSPERO/ 注册，PROSPERO 编号：CRD42019127648。
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