非小细胞肺癌患者ERCC1蛋白表达与铂类化疗敏感性的Meta分析

Meta-Analysis of Predictive Value of ERCC1 Protein Expression in Non-Small Cell Lung Cancer Patients Receiving Platinum-Based Chemotherapy

目的对非小细胞肺癌患者核苷酸切除修复交叉互补酶1(ERCC1)蛋白表达水平与铂类化疗敏感性的相关性进行Meta分析。方法计算机检索中国期刊全文数据库、万方数据库、PubMed、EMBASE和ASCO数据库,手工检索已发表与未发表的资料。收集比较不同核苷酸切除修复交叉互补酶1蛋白表达水平的晚期非小细胞肺癌患者对接受铂类为基础的化疗方案的反应率的文章。采用Cochrane协作网RevMan4.2软件进行分析。结果最终纳入14项研究,共1086名患者。524名ERCC1阳性患者,合并有效率为28.1%;562名ERCC1阴性患者,合并有效率为46.6%。异质性检验显示χ2=22.93,P=0.04,采用随机效应模型进行分析,合并优势比为1.92,95%可信区间为1.48～2.49。结论晚期非小细胞肺癌切除修复交叉互补酶1蛋白阴性表达患者对铂类化疗敏感性优于切除修复交叉互补酶1蛋白阳性表达的患者。

Objective To examine ERCC1 protein expression and sensitivity to platinum-based chemotherapy in non-small cell lung cancer（NSCLC）patients.Methods We electronically searched the CNKI,WANFANG,PubMed,EMBASE and ASCO proceedings.We also hand-searched some published and unpublished references.Inclusion criteria were NSCLC patients,received platinum-based chemotherapy,evaluation of ERCC1 expression and overall response rate.Meta-analysis was conducted by The Corhrane Collaboration＇s RevMan 4.2 software.Results We finally identified fourteen studies with 1 086 patients.The number of patients with high ERCC1 protein expression was 524 and the response rate to platinum-based chemotherapy was 28.1%.Patients with negative ERCC1 protein expression were 562 and the response rate to platinum-based chemotherapy was 46.6%.The test for heterogeneity showed that all eligible had heterogeneity（χ^2=22.93,P=0.04）.The combined odds ratio（OR）was 1.92,with 95% confidence interval of 1.48～2.49.Conclusion Compared to patients with positive ERCC1 protein expression,the patients with negative ERCC1 protein expression in advanced NSCLC were more sensitive to platinum-based chemotherapy.