多药耐药基因及其表达产物对非小细胞肺癌化疗疗效影响的Meta分析  

Meta-analysis of predictive value of multidrug resistance-1 and protein expression in non-small cell lung cancer patients with chemotherapy

作　　者：韩冰[1] 马列[1] 赵明静[1] 毛世涛[1] 王笑歌[1] 

机构地区：[1]中国医科大学附属第四医院呼吸内科,辽宁沈阳110032

出　　处：《现代肿瘤医学》2011年第12期2429-2434,共6页Journal of Modern Oncology

基　　金：辽宁省教育厅计划项目(编号:05L469)

摘　　要：目的:应用循证医学方法评价多药耐药基因及其表达产物对非小细胞肺癌化疗疗效影响。方法:计算机检索中国学术期刊数据库(1990-2010)及MEDLINE(1990-2010),纳入有关MDR1/P-gp表对非小细胞肺癌化疗疗效影响的随机对照试验组,对纳入的文献进行质量评分,并提取有效数据进行分析。结果:共检索出相关文献176篇,经过层层筛选,有8个符合标准的研究被纳入,合计301例患者。Meta分析结果显示:MDR1/P-gp(+)与MDR1/P-gp(-)的非小细胞肺癌患者相比,MDR1/P-gp(+)可降低化疗疗效,其OR为0.16(95%CI 0.05-0.47),P=0.001,差异有统计学意义。进而对纳入的研究进行分层分析后发现,研究质量评分≥8分的研究Meta分析结果显示优势比OR=0.11(95%CI 0.02-0.78),P=0.03;研究质量评分<8分的研究Meta分析结果显示优势比OR=0.18(95%CI 0.08-0.38),P<0.00001,差异均有统计学意义。结论:目前研究表明MDR1/P-gp表达阳性患者的化疗疗效优于MDR1/P-gp表达阴性的患者。Objective：To evaluate the impact of multidrug resistance-1 and protein expression on chemotherapy response in non-small cell lung cancer patients with evidence-based medicine methods.Methods： We electronically searched the Chinese Academic Journals Database（1990-2010） and MEDLINE（1990-2010）,got the randomized controlled trials regarding impact of multidrug resistance-1 and protein expression on chemotherapy response in non-small cell lung cancer patients.A meta-analysis was carried out by collecting information based on inclusion and exclusion criteria from all studies available.Results： The meta-analysis included 8 trials from 176 studies,a total of 301 patients were included in the analysis.Meta-analysis showed： there was statistical significant in response rate between MDR1/P-gp（＋） and MDR1/ P-gp（-） non-small cell lung cancer patients on chemotherapy,the OR was 0.16（95% CI 0.05-0.47）,P=0.001.After further analysis,there was statistical significant in response rate between MDR1/P-gp（＋） and MDR1/ P-gp（-） non-small cell lung cancer patients on chemotherapy among these studies that quality score≥8points,the OR was 0.11（95% CI 0.02-0.78）,P=0.03.There was statistical significant in response rate between MDR1/P-gp（＋） and MDR1/ P-gp（-） non-small cell lung cancer patients on chemotherapy among these studies that quality score8points,the OR was 0.18（95% CI 0.08-0.38）,P〈0.00001.Conclusion： Present studies show that compared to the non-small cell lung cancer patients with positive MDR1/P-gp,the non-small cell lung cancer patients with negative MDR1/P-gp will get better response to chemotherapy.

关 键 词：多药耐药基因 P-糖蛋白 非小细胞肺癌 META分析 

分 类 号：R734.2[医药卫生—肿瘤]