Wu Pei, Wen Zelin
Department of Gastrointestinal Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2025 Mar 12;15:1470939. doi: 10.3389/fonc.2025.1470939. eCollection 2025.
Chemosensitivity and radiosensitivity are associated with the prognosis of colorectal cancer, and the expression of the ataxia-telangiectasia mutated (ATM) protein plays an essential role in these processes. The present study examined the relationship between ATM expression and the survival outcomes of colorectal cancer patients and explored the underlying mechanism and promising therapeutic strategies.
A search including medical subject headings (MeSH), free terms, and combined words was conducted using Pubmed, EMBASE, and Cochrane. Studies had to meet the inclusion criteria as well as include processes such as data extraction and quality evaluation. The survival outcomes were assessed using hazard ratio (HR) and 95% confidence interval (CI). Heterogeneity, and publication bias were analyzed, and a P value <0.05 was considered statistically significant.
Nine studies with 2883 patients were included in the meta-analysis. Low ATM expression level was related to poor overall survival (HR=0.542, 95% CI=0.447-0.637; P=0.000). Disease-free, progression-free, and recurrence-free survival rates were lower in patients with low ATM expression than in those with high ATM expression. There was no significant difference between Stage I-II and Stage III-IV colorectal cancer patients [risk ratio (RR)=1.173, 95% CI=0.970-1.417, P=0.690].
Low ATM expression level may be a marker of poor survival in colorectal cancer and contributes to resistance to therapy. Targeting related factors in these pathways to sensitize tumors to treatment is a potential therapeutic strategy, and monitoring ATM status could be a valuable guide independent of the immunotherapy or chemotherapy strategy used.
化疗敏感性和放射敏感性与结直肠癌的预后相关，共济失调毛细血管扩张突变（ATM）蛋白的表达在这些过程中起重要作用。本研究探讨了ATM表达与结直肠癌患者生存结局之间的关系，并探索其潜在机制和有前景的治疗策略。
使用PubMed、EMBASE和Cochrane进行检索，检索词包括医学主题词（MeSH）、自由词和组合词。纳入的研究必须符合纳入标准，并包括数据提取和质量评估等过程。使用风险比（HR）和95%置信区间（CI）评估生存结局。分析异质性和发表偏倚，P值<0.05被认为具有统计学意义。
荟萃分析纳入了9项研究，共2883例患者。ATM低表达水平与总体生存率差相关（HR=0.542，95%CI=0.447-0.637；P=0.000）。ATM低表达患者的无病生存率、无进展生存率和无复发生存率低于高表达患者。I-II期和III-IV期结直肠癌患者之间无显著差异[风险比（RR）=1.173，95%CI=0.970-1.417，P=0.690]。
ATM低表达水平可能是结直肠癌患者生存不良的一个标志物，并导致治疗抵抗。针对这些途径中的相关因素使肿瘤对治疗敏感是一种潜在的治疗策略，监测ATM状态可能是一种有价值的指导，与所采用的免疫治疗或化疗策略无关。
