黏蛋白家族成员与胰腺癌患者预后意义的相关性：一项荟萃分析。
Association of mucin family members with prognostic significance in pancreatic cancer patients: A meta-analysis.
机构信息
Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Emergency Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
出版信息
PLoS One. 2022 Jun 16;17(6):e0269612. doi: 10.1371/journal.pone.0269612. eCollection 2022.
OBJECTIVE
The role of biomarkers in the early diagnosis and prognosis prediction of tumors has been paid more and more attention by researchers. Mucins are markers that have been found to have an abnormal expression in many tumors in recent years, which have been proved to have a predictive effect on the prognosis of tumors such as cholangiocarcinoma and colon cancer. However, whether it can predict the prognosis of pancreatic cancer remains unknown. The purpose of our study is to investigate whether the mucins and their subtypes are related to the prognosis of patients with pancreatic cancer.
METHODS
We systematically searched the Pubmed, Embase, and Cochrane Library for all eligible studies on the relationship between mucin and the prognosis of patients with pancreatic cancer up to November 2021. We used R 4.12 to calculate the combined risk ratio (HR) and 95% confidence interval (CI). For studies that did not provide HR values, we used scientific methods to calculate their values as accurately as possible. We used fixed effect model due to low heterogeneity. Subgroup analysis and sensitivity analysis were used to study heterogeneity. The funnel plot and Egger test were used to test whether the publication bias existed. The trim and filling method were used to evaluate the impact of publication bias on the results of the study.
RESULTS
A total of 18 studies were included in this meta-analysis, including 4 subtypes of mucin family members and 1643 patients. There was a slight heterogeneity between studies (I2 = 24.4%, P = 0.14). Meta-analysis showed that MUC4 (HR = 2.04, 95%CI 1.21;3.45), MUC16 (HR = 2.10, 95%CI 1.31;3.37), and whole mucin (HR = 1.32, 95%CI 1.07;1.63). The expression level was negatively correlated with the prognosis of pancreatic cancer patients, MUC1 (HR = 1.09, 95%CI 0.77;1.54), MUC5 (HR = 1.03, 95%CI 0.47;2.25) The expression level was not related to the prognosis of pancreatic cancer patients.
CONCLUSION
The meta-analysis demonstrated that the overall expression level of mucin and the expression levels of MUC4 and MUC16 were important prognostic predictors for pancreatic cancer patients. MUC1 and MUC5 had no predictive value for the prognosis of pancreatic cancer patients. Future studies should validate these and other promising biomarkers.
TRIAL REGISTRATION
PROSPERO registration number is CRD42021291962. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021291962.
目的
生物标志物在肿瘤的早期诊断和预后预测中的作用越来越受到研究人员的关注。近年来发现黏蛋白在许多肿瘤中表达异常，已被证明对胆管癌和结肠癌等肿瘤的预后具有预测作用。然而，它是否能预测胰腺癌的预后尚不清楚。本研究旨在探讨黏蛋白及其亚型是否与胰腺癌患者的预后有关。
方法
我们系统地检索了 Pubmed、Embase 和 Cochrane Library 中截至 2021 年 11 月所有关于黏蛋白与胰腺癌患者预后关系的相关研究。我们使用 R 4.12 计算合并风险比（HR）和 95%置信区间（CI）。对于未提供 HR 值的研究，我们使用科学方法尽可能准确地计算其值。由于异质性较低，我们使用固定效应模型。亚组分析和敏感性分析用于研究异质性。漏斗图和 Egger 检验用于检验是否存在发表偏倚。使用修剪和填充法评估发表偏倚对研究结果的影响。
结果
共有 18 项研究纳入本荟萃分析，包括黏蛋白家族的 4 个亚型和 1643 名患者。研究之间存在轻微的异质性（I2=24.4%，P=0.14）。荟萃分析显示，MUC4（HR=2.04，95%CI 1.213.45）、MUC16（HR=2.10，95%CI 1.313.37）和全黏蛋白（HR=1.32，95%CI 1.071.63）表达水平与胰腺癌患者的预后呈负相关，MUC1（HR=1.09，95%CI 0.771.54）、MUC5（HR=1.03，95%CI 0.47~2.25）表达水平与胰腺癌患者的预后无关。
结论
荟萃分析表明，黏蛋白的整体表达水平以及 MUC4 和 MUC16 的表达水平是胰腺癌患者重要的预后预测指标。MUC1 和 MUC5 对胰腺癌患者的预后无预测价值。未来的研究应验证这些和其他有前途的生物标志物。
试验注册
PROSPERO 注册号为 CRD42021291962。https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021291962。
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