Toll样受体与肿瘤预后相关性的Meta分析  

The relationship between Toll-like receptors and tumor prognosis:A Meta-analysis

作　　者：丁桂清 马金昀 彭小燕 王元花 张云超 程晓东 DING Guiqing;MA Jinyun;PENG Xiaoyan;WANGYuanhua;ZHANG Yunchao;CHENG Xiaodong(Institute of Clinical Immunology,Yueyang Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院临床免疫研究所,上海200437

出　　处：《现代肿瘤医学》2021年第21期3804-3812,共9页Journal of Modern Oncology

基　　金：国家自然科学基金项目(编号:81673669,81703782,81973543);上海市交叉学科“中医临床免疫学”建设项目(编号:30304113598);上海市中医药三年行动计划ZY[编号:(2018-2020)-CCCX-2004-09];上海市“科技创新行动计划”项目(编号:19401901600)。

摘　　要：目的:系统评价Toll样受体(Toll-like receptors,TLRs)在肿瘤组织中的表达水平及与肿瘤患者预后的相关性。方法:计算机检索中国期刊全文数据库(CNKI)、万方数据库(WF)、中文科技期刊数据库(VIP)、中国生物医学文献服务系统(Sinomed)、PubMed、The Cochrane Library、EMbase数据库,收集TLRs与肿瘤预后相关性的病例对照研究,检索时间为自建库起截止至2020年09月04日。根据纳入排除标准对文献进行筛选,经质量评价、数据提取后使用Stata 15.0软件对总生存期(overall survival,OS)、无进展生存期(disease-free survial,DFS)进行Meta分析。结果:最终纳入35篇文献,共4472例患者,其中24篇涉及TLR4,7篇涉及TLR3,7篇涉及TLR9。结果表明,与对照组相比,TLR4阳性或高表达组肿瘤患者OS及DFS较短(HR=0.342,95%CI:0.098~0.586,P=0.006;HR=0.543,95%CI:0.278~0.809,P=0.000)。TLR3阳性/高表达与晚期患者较好预后相关(HR=-1.086,95%CI:-1.716~-0.455,P=0.001)。TLR9阳性/高表达与早期患者的不良预后相关(HR=0.656,95%CI:0.250~1.063,P=0.002)。结论:不同亚型TLRs在肿瘤中发挥的作用不同,TLR4和TLR9阳性/高表达与肿瘤不良预后相关,TLR3阳性/高表达与晚期肿瘤患者较好预后相关,TLR3、TLR4、TLR9有望成为预测肿瘤预后的新型标志物。Objective:To systematically evaluate the effect of Toll like receptors(TLRs)expression in tumor tissues on the prognosis of patients with tumor disease.Methods:CNKI,WF,VIP,Sinomed,PubMed,the Cochrane Library and EMbase were searched to collect the case-control studies on the correlation between TLRs and tumor prognosis.The retrieval time was from the establishment of the database to September 4,2020.After quality evaluation and data extraction,the overall survival(OS)and disease free survival(DFS)were analyzed by Stata 15.0 software.Results:Totally 4472 patients were included in 35 literatures,24 involved TLR4,7 of which involved TLR3 and TLR9 respectively.The results showed that the OS and DFS of TLR4 positive or high expression group were shorter than those of control group(HR=0.342,95%CI:0.098~0.586,P=0.006,HR=0.543,95%CI:0.278~0.809,P=0.000).The positive or high expression of TLR3 was associated with better prognosis in advanced stage(HR=-1.086,95%CI:-1.716~-0.455,P=0.001).The positive or high expression of TLR9 was associated with poor prognosis in early stage(HR=0.656,95%CI:0.250~1.063,P=0.002).Conclusion:TLRs play different roles in tumor cells.The positive or high expression of TLR4 and TLR9 is negatively correlated with tumor prognosis,while the positive or high expression of TLR3 was associated with better prognosis of patients with advanced tumor disease.TLR3,TLR4 and TLR9 are expected to become new markers to predict the prognosis of tumors.

关 键 词：TOLL样受体 肿瘤 预后 META分析 

分 类 号：R730.5[医药卫生—肿瘤]