p53蛋白表达与胰腺癌淋巴结转移、脉管浸润、神经浸润相关性的系统评价和Meta分析  

Systematic review and meta-analysis of relationship between p53 protein expression and lymph node metastasis,vascular invasion,and perineural invasion in pancreatic cancer

作　　者：贾明昊 张石垒 刘铁兵 角逸飞 刘现立[1] 刘江波[2] Ming-Hao Jia;Shi-Lei Zhang;Tie-Bing Liu;Yi-Fei Jue;Xian-Li Liu;Jiang-Bo Liu(Department of Gastrointestinal Surgery,The First Affiliated Hospital,College of Clinical Medicine,Henan University of Science and Technology,Luoyang 471003,Henan Province,China;Department of Thyroid and Breast Surgery,The First Affiliated Hospital,College of Clinical Medicine,Henan University of Science and Technology,Luoyang 471003,Henan Province,China;Department of Hepatobiliary Surgery,The First Affiliated Hospital,College of Clinical Medicine,Henan University of Science and Technology,Luoyang 471003,Henan Province,China)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院胃肠外科,河南省洛阳市471000 [2]河南科技大学临床医学院,河南科技大学第一附属医院乳腺肿瘤外科,河南省洛阳市471000 [3]河南科技大学临床医学院,河南科技大学第一附属医院肝胆外科,河南省洛阳市471000

出　　处：《世界华人消化杂志》2024年第5期376-386,共11页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助-河南人才培养联合项目,No.U1504815;河南省重点研发与推广专项(科技攻关)项目,No.212102310129.

摘　　要：背景胰腺癌相关死亡达恶性肿瘤死亡第3位.淋巴结转移、神经浸润可显著影响胰腺癌术后复发转移.抑癌基因p53突变在胰腺癌发生发展中扮演重要角色,但p53蛋白表达与胰腺癌淋巴结转移、神经浸润相关性尚无统一证据.目的通过系统评价和Meta分析评价p53蛋白表达与胰腺癌淋巴结转移、脉管浸润和神经浸润三项侵袭特征的相关性.方法对2023-08-31之前发表的相关文献进行系统检索.采用Meta分析评估p53蛋白表达与淋巴结转移、脉管浸润和神经浸润的相关性,并进行亚组分析、敏感性分析、和发表偏倚分析.结果共有14项研究被纳入Meta分析.胰腺癌组织p53蛋白平均表达率为35.6%,p53蛋白表达与胰腺癌患者的侵袭特征显著相关:胰腺癌p53蛋白高表达与低表达组相比,淋巴结转移、脉管浸润和神经浸润发生的危险度比分别为:1.29[95%置信区间(confidence interval,CI):1.10-1.50]、1.23[95%CI:1.03-1.47]和1.22[95%CI:1.00-1.48].亚组分析显示,研究人群、样本量、和发表时间可影响总Meta分析结果.敏感性分析可改变脉管浸润和神经浸润研究的总效应量,但不改变淋巴结转移的效应量.发表偏倚分析显示神经浸润研究存在发表偏倚,而淋巴结转移和脉管浸润研究无发表偏倚.结论p53蛋白表达是胰腺癌淋巴结转移、脉管浸润和神经浸润的危险因素,临床上检测癌组织p53蛋白表达可为评估胰腺癌侵袭特征提供分子病理依据.BACKGROUND Pancreatic cancer is the third leading cause of deaths among malignant tumors.Lymph node metastasis(LNM)and perineural invasion(PNI)can significantly affect the recurrence and metastasis of pancreatic cancer after surgery.The tumor suppressor gene p53 mutations play an important role in the occurrence and development of pancreatic cancer,but there is no unified evidence that p53 protein expression is associated with LNM and PNI in pan-creatic cancer.AIM To investigate the relationship between p53 protein expression and the three invasion characteristics of pancreatic cancer,including LNM,vascular invasion(VI),and PNI,via a systematic review and meta-analysis.METHODS A systematic literature search was conducted to retrieve relevant published studies before August 31,2023.Meta-analysis was performed to evaluate the correlation between p53 protein expression and LNM,VI,and PNI.Subgroup analysis,sensitivity analysis,and publication bias analysis of the included studies were also conducted.RESULTS Fourteen studies were finally included in the meta-analysis.The average expression rate of p53 protein in pancreatic cancer was 35.6%.p53 protein expression was significantly related to the invasion characteristics of pancreatic cancer:The risk ratio of LMN in patients with p53 protein high-expression vs low-expression was 1.29[95%confidence interval(CI):1.10-1.50];the corresponding ratio of VI and PNI was 1.23[95%CI:1.03-1.47]and 1.22[95%CI:1.00-1.48],respectively.Subgroup analysis showed that study population,sample size,and publication date could influence the overall meta-analysis results.Sensitivity analysis altered the overall analytical statistics of VI or PNI studies but not LNM.Publication bias analysis showed that there was publication bias in the PNI studies,but there was no publication bias in the LNM and VI studies.CONCLUSION p53 protein expression is a risk factor for LNM,VI,and PNI in pancreatic cancer.Clinical detection of p53 protein expression in cancer tissue can provide a molecular patho-logica

关 键 词：胰腺癌 抑癌基因P53 淋巴结转移 脉管浸润 神经浸润 META分析 

分 类 号：R735.9[医药卫生—肿瘤]