结直肠癌微卫星不稳定与预后、化疗效果关系的Meta分析  

A Meta-analysis of microsatellite instability as a factor of prognosis and response to chemotherapy for colorectal cancer

作　　者：徐燕[1] 王胜强[1] 廖开友[1] 吴毅[1] 牟燕飞[1] 

机构地区：[1]重庆市肿瘤研究所综合科,400030

出　　处：《肿瘤研究与临床》2013年第8期530-534,共5页Cancer Research and Clinic

摘　　要：目的 评估微卫星不稳定（MSI）与结直肠癌预后及化疗的关系。方法 检索2000年1月至2012年10月间发表的关于结直肠癌MSI的文献。英文文献采用Web of Knowledge和MEDLINE（PubMed）数据库，中文文献采用中国期刊全文数据库（CNKI）、万方数字化期刊全文数据库和维普数据库进行检索。使用Comprehensive Meta Analysis V2软件对MSI与结直肠癌预后、化疗效果的关系分别进行Meta分析。结果 共纳入符合标准的文献30篇。高度微卫星不稳定（MSI-H）对于患者的总生存（OS）具有保护作用（OR＝0.634，95 % CI 0.558～0.720，P＜0.001）；MSI-H对于患者的无病生存（DFS）也具有保护作用（OR＝0.571，95 % CI 0.479～0.681，P＜0.001）。微卫星稳定或低微卫星不稳定（MSS／MSI-L）组患者进行氟尿嘧啶（5-Fu）化疗生存率可明显提高（OR＝0.515，95 % CI 0.433～0.611，P＜0.001）；MSI-H组患者是否进行5-Fu化疗生存率差异无统计学意义（OR＝0.631，95 % CI 0.302～1.318，P＝0.220）。结论 MSI-H分型患者的OS和DFS均好于MSS／MSI-L分型患者。对于MSS／MSI-L分型的患者，5-Fu辅助化疗的疗效显著，而对于MSI-H分型的患者，应用5-Fu与未应用者生存率相似。Objective To investigate the correspond of microsatellite instability （MSI） on the prognosis and the effect of chemotherapy for colorectal cancer. Methods The publications about the MSI of colorectal cancer from January 2011 to October 2012 were searched. The Web of Knowledge and MEDLINE （PubMed） databases were used for searching English articles. The CNKI and WanFang databases were used for searching Chinese articles. Statistical analysis and graphics were performed with Comprehensive Meta Analysis V2 software.Results Thirty papers were included in this study. For the prognostic Meta-analysis, MSI-H was a protective factor for the overall survival of patients （OR = 0.634, 0.558-0.720; P 〈 0.001）. Simultaneously, MSI-H was a protective factor for the disease-free survival of patients （OR = 0.571, 0.479-0.681; P 〈 0.001）. After using of 5-Fu, the survival rate of MSS/MSI-L patients could be significantly elevated （OR = 0.515, 0.433-0.611; P 〈 0.001）. However, the survival rate of MSI-H patients did not increase significantly （0.631, 0.302-1.318; P = 0.220）. Conclusions Both the overall survival and disease-free survival of MSI-H patients were significantly better than that of MSS/MSI-L patients. For MSS/MSI-L patients, the chemotherapy effect was remarkable. However, for MSI-H patients, there was no statistics difference between chemotherapy and no-chemotherapy group.

关 键 词：结直肠肿瘤 微卫星不稳定性 预后 META分析 

分 类 号：R735.3[医药卫生—肿瘤]