Guilin Medical University, Department of Respiratory and Critical care Medicine, Affiliated Hospital of Guilin Medical University.
Department of Urology, Affiliated Hospital of Guilin Medical University.
Medicine (Baltimore). 2021 Apr 16;100(15):e25332. doi: 10.1097/MD.0000000000025332.
A lot of research evidence shows that exosomes play an indelible role in the prognosis of lung cancer, but there are many disputes. Therefore, we conduct a meta-analysis to further demonstrate.
A literature retrieval was performed through a search of PubMed, Embase, Web of Science, Cochrane, CKNI, Wanfang, and other databases to locate documents from the literature that satisfied the inclusion criteria. There were four outcome indicators: overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), and progression-free survival (PFS). Subgroup analysis was conducted according to sample size, country, detection method, analysis method, and pathological type. Stata 14.0 software was used to evaluate the prognostic value of exosomes in lung cancer.
A total of 2456 patients with lung cancer from 29 studies in 16 articles were included. The expression level of exosomes was closely associated with the OS and DFS of patients, although no statistical difference was observed between exosomes and DSS or PFS. Eighteen studies with 2,110 patients were evaluated to examine the prognostic value of exosomes in lung cancer by exploring the association between exosomes and OS. The results showed that exosomes were strongly associated with worse OS, and the combined hazard ratio (HR) was 2.01 (95% confidence interval [CI]: 1.70-2.39, P = .000). Six studies investigated the association between exosomes and DFS, and showed a pooled HR of 2.48 (95% CI: 1.75-3.53, P = .000).
Our analysis indicated that the expression level of exosomes was closely associated with the OS and DFS of patients with lung cancer, suggesting that exosomes are associated with poor prognosis of lung cancer. Exosomes may be a new biomarker for the prognosis of lung cancer, although a large number of prospective studies are still needed to support this.
大量研究证据表明,外泌体在肺癌预后中起着不可磨灭的作用,但存在许多争议。因此,我们进行了一项荟萃分析以进一步证明。
通过检索 PubMed、Embase、Web of Science、Cochrane、中国知网、万方等数据库,查找符合纳入标准的文献。共有四个结局指标:总生存期(OS)、无病生存期(DFS)、疾病特异性生存期(DSS)和无进展生存期(PFS)。根据样本量、国家、检测方法、分析方法和病理类型进行亚组分析。使用 Stata 14.0 软件评估外泌体在肺癌中的预后价值。
共纳入 29 篇文献中的 2456 例肺癌患者。外泌体的表达水平与患者的 OS 和 DFS 密切相关,尽管外泌体与 DSS 或 PFS 之间无统计学差异。18 项研究共 2110 例患者评估了外泌体在肺癌中的预后价值,通过探讨外泌体与 OS 的关系。结果表明,外泌体与较差的 OS 密切相关,合并危险比(HR)为 2.01(95%置信区间 [CI]:1.70-2.39,P =.000)。6 项研究探讨了外泌体与 DFS 的关系,合并 HR 为 2.48(95% CI:1.75-3.53,P =.000)。
我们的分析表明,外泌体的表达水平与肺癌患者的 OS 和 DFS 密切相关,提示外泌体与肺癌的不良预后有关。外泌体可能是肺癌预后的一个新的生物标志物,但仍需要大量前瞻性研究来支持这一观点。