β2-微球蛋白与非霍奇金淋巴瘤预后关系的Meta分析  

Prognostic value of beta2-microglobulin in non-Hodgkin’s lymphoma:A meta-analysis

作　　者：吴丽[1,2] 谢开鹏[1,3] 王彤[1] 闫丽娜[4] 归薇[5] 王慧[1] 张秀秀[1] 韩婷[1] 

机构地区：[1]山西医科大学公共卫生学院卫生统计学教研室,太原030001 [2]浙江中医药大学附属第二医院医务部统计室 [3]南京医科大学公共卫生学院流行病与卫生统计学系 [4]河北医科大学公共卫生学院流行病与卫生统计学教研室 [5]山西省肿瘤医院血液科

出　　处：《现代预防医学》2013年第3期401-405,407,共6页Modern Preventive Medicine

基　　金：国家自然科学基金(81072385)

摘　　要：目的β2-微球蛋白对非霍奇金淋巴瘤患者的预后影响一直都存有争议,本文应用Meta分析的方法,综合定量评价β2-微球蛋白在非霍奇金淋巴瘤总体生存中的预后价值。方法依据一定纳入排除标准,通过Pubmed,Science Direct和OVID数据库检索1980～2010年的相关文献,提取或估算β2-微球蛋白正常组和升高组总体生存率的风险比并采用固定效应模型和随机效应模型对其合并,依据单/多因素进行亚组分析,采用敏感性分析,估计合并风险比的变化情况。同时,采用漏斗图和失安全系数估计发表偏倚。结果共纳入16篇符合要求的文献,累计病例2227例。异质性检验结果提示,各研究间具有异质性(χ2=85.68,P﹤0.001,I2=82%,df=15),在随机效应模型下,合并的风险比为2.67(95%CI1.86～3.83)。总体效应的检验具有统计学意义(Z=5.32,P﹤0.001)。结论升高的β2-微球蛋白水平是非霍奇金淋巴瘤预后生存的独立危险因素,这一发现有利于为非霍奇金淋巴瘤的治疗策略提供依据。OBJECTIVE To comprehensively and quantitatively assess the prognostic value of beta2-microglobulin （β2-MG） in non-Hodgkin＇s lymphoma （NHL） via meta- analysis. METHODS Pubmed, Science Direct and OVID database in English from 1980 to 2010 were all searched to extract relevant information using retrieval strategy by two assessors. The hazard ratio （HR） estimates of overall survival （OS） between elevated and normal groups of β2-MG were derived or calculated. Fixed and random effects models were successively used to synthesize the HRs. The subgroup analysis and the sensitivity analysis were con- ducted to evaluate how the pooled effect would be changed by dividing into two groups or by eliminating the inferior quality of HRs, respectively. Meanwhile, funnel plot and fail safe number （Nfs） were used to estimate the publication bias. RESULTS A total of 16 articles were included in the meta-analysis. The cumulative number of patients with NHL was 2 227. Homogeneity test showed that heterogeneity between studies exists （P = 82%, P〈 0.001）. The pooled hazard ratio was 2.67 （95%CI： 1.86- 3.83） and the overall effect were confirmed to be statistically significant （Z = 5.32, P 〈 0.001 ）. Subgroup and sensitivity analy- sis also revealed that β2-MG was an important hazard factor to NHL patients. CONCLUSION Combined hazard ratios suggest that elevated β2-MG may be a useful independent prognostic factor for NHL.

关 键 词：Β2-微球蛋白 非霍奇金淋巴瘤 META分析 

分 类 号：R733.4[医药卫生—肿瘤]