非小细胞肺癌基因重排患者的临床特征：一项荟萃分析
Clinical characteristics of patients with gene rearrangement in non-small cell lung cancer: a meta-analysis.
作者信息
Bi Huanhuan, Ren Dunqiang, Ding Xiaoqian, Yin Xiaojiao, Cui Shichao, Guo Caihong, Wang Hongmei
机构信息
Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266000, China.
出版信息
Transl Cancer Res. 2020 Jul;9(7):4383-4392. doi: 10.21037/tcr-20-1813.
BACKGROUND
gene rearrangement has been reported in several types of cancers, including non-small cell lung cancer (NSCLC). It is reported that tyrosine kinase inhibitors are effective in the treatment of rearranged NSCLC. Therefore, the identification of rearrangement can be used as potential therapeutic target in lung cancer. Epidemiological data indicates that gene rearrangement occurs in approximately 1-2% of NSCLC patients. The small sample sizes of the existing associated studies only represent the characteristics of patients in specific regions or countries, and there is still no latest statistical analysis on gene rearrangement anywhere in the world.
METHODS
We conducted a systematic search of the PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CBM, CNKI, Wanfang, and VIP databases to identify studies on gene rearrangement in NSCLC patients from January 1, 2015 to October 27, 2019. We conducted a meta-analysis to investigate the relationship between gene rearrangement and clinical characteristics of NSCLC patients. The four clinical features are as follows: gender, smoking status, pathological type, and lung cancer stage.
RESULTS
Thirty-nine studies constituting of 25,055 NSCLC patients were eligible for inclusion in this meta-analysis. A prominently higher rate of gene rearrangement was observed in female NSCLC patients (OR =1.94, 95% CI: 1.62-2.32%, P<0.05), patients with no smoking history (OR =2.82, 95% CI: 2.24-3.55%, P<0.05), patients with adenocarcinoma (OR =1.55, 95% CI: 1.14-2.11%, P<0.05), and patients with stage III-IV disease (OR =1.50, 95% CI: 1.15-1.94%, P<0.05). Our meta-analysis also showed that the prevalence of rearrangement in adenocarcinoma was 2.49% (95% CI: 1.92-3.11%), while it was lower in non-adenocarcinoma patients (1.37%).
CONCLUSIONS
gene rearrangement was more predominant in female patients, patients without smoking history, patients with adenocarcinoma and patients with advanced-stage disease (stages III to IV).
背景
基因重排在包括非小细胞肺癌（NSCLC）在内的多种癌症类型中均有报道。据报道，酪氨酸激酶抑制剂对重排的NSCLC治疗有效。因此，基因重排的鉴定可作为肺癌潜在的治疗靶点。流行病学数据表明，基因重排在约1%-2%的NSCLC患者中发生。现有相关研究的样本量较小，仅代表特定地区或国家患者的特征，且全球范围内仍没有关于基因重排的最新统计分析。
方法
我们对PubMed、Embase、Cochrane对照试验中心注册库（CENTRAL）、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据库和维普数据库进行了系统检索，以识别2015年1月1日至2019年10月27日期间关于NSCLC患者基因重排的研究。我们进行了一项荟萃分析，以研究基因重排与NSCLC患者临床特征之间的关系。这四个临床特征如下：性别、吸烟状况、病理类型和肺癌分期。
结果
39项研究共纳入25,055例NSCLC患者，符合本次荟萃分析的纳入标准。在女性NSCLC患者（OR =1.94，95%CI：1.62-2.32%，P<0.05）、无吸烟史患者（OR =2.82，95%CI：2.24-3.55%，P<0.05）、腺癌患者（OR =1.55，95%CI：1.14-2.11%，P<0.05）以及III-IV期疾病患者（OR =1.50，95%CI：1.15-1.94%，P<0.05）中观察到基因重排率显著更高。我们的荟萃分析还表明，腺癌中基因重排的患病率为2.49%（95%CI：1.92-3.11%），而非腺癌患者中患病率较低（1.37%）。
结论
基因重排在女性患者、无吸烟史患者、腺癌患者和晚期疾病（III至IV期）患者中更为常见。
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