Survivin和Cox-2蛋白与非小细胞肺癌危险因素的系统评价

Survivin,Cox-2 protein and risk factors in non-small cell lung cancer:a systematic review

目的:系统评价存活蛋白(Survivin)、环氧化酶2(cyclooxygenase 2,Cox-2)表达水平与非小细胞肺癌non-small cell lungcancer,NSCLC)危险因素的关系。方法:计算机检索Cochrane Library(2011年第1期),PubMed、CNKI等数据库,并辅以手工检索,按照纳入与排除标准选择病例对照试验。评价质量及提取资料后,采用RevMan 4.2.10软件对数据库进行系统评价。结果:对于Survivin,共纳入15个研究,其中1 222例NSCLC患者,447例正常对照。Meta分析结果显示:Survivin在NSCLC组及正常对照组[比值比(odds ratio,OR)=11.11,95%可信区间(confidenceinterval,CI)为5.92～20.83]的表达差异具有统计学意义(P<0.05)。临床病理检查结果显示:Survivin在TNM分期T3～T4期与T1～T2期,临床分期Ⅲ～Ⅳ期与Ⅰ～Ⅱ期,淋巴结转移组与非淋巴结转移组,低分化组与中高分化组间的表达差异均具有统计学意义(P均<0.05)。对于Cox-2,共纳入12个研究,其中975例NSCLC患者,209例正常对照。Meta分析结果显示:Cox-2在NSCLC组及正常对照组(OR=29.46,95%CI=15.91～54.56)的表达差异具有统计学意义(P<0.05)。临床病理检查结果显示:Cox-2在TNM分期T3～T4期与T1～T2期的表达差异无统计学意义(P>0.05)。Cox-2在临床分期Ⅲ～Ⅳ期与Ⅰ～Ⅱ期,淋巴结转移组与非淋巴结转移组,低分化组与中高分化组间的表达差异均具有统计学意义(P均<0.05)。Spearman等级相关分析显示,Survivin与Cox-2蛋白阳性率在NSCLC中的表达具有相关性(r=0.514,P<0.05)。结论:Survivin、Cox-2在NSCLC中高表达,增加了其恶性行为的发生危险,同时Survivin与Cox-2在NSCLC表达也有一定的相关性。

OBJECTIVE：To investigate Survivin,Cox-2 protein and risk factors in non-small cell lung cancer（NSCLC） with a systematic review.METHODS：The published studies were searched in the Cochrane Library （Issue 1,2011）,Pubmed and CNKI databases,and other relevant journals were also handsearched to identify all the relevant case-control trials.Then the quality of the included trials was assessed and meta-analysis were performed by RevMan 4.2.10 software.RESULTS：For Survivin,including 1 222 cases and 447 controls in 15 studies,the positive rate showed significant differences between NSCLC and normal lung tissues（OR=11.11,95%CI=5.92-20.83,P 〈 0.05）. There were significant differences between T stages HI -IV and stagesⅠ-Ⅱ,clinic stagesⅢ-Ⅳand stagesⅠ-Ⅱ,lymph node metastasis and non-lymph node metastasis,cell differentiation G3 and cell differentiation G1- G2（P〈0.05）.For Cox-2,including 975 cases and 209 controls in 12 studies,the positive rate of expression revealed significant differences between NSCLC and normal lung tissues（OR=29A6,95%CI=15.91-54.56,P〈0.05）.No significant difference was found between T stagesⅢ-Ⅳand stagesⅠ-Ⅱ（P〉0.05）.There were significant differences between clinic stagesⅢ-Ⅳand stagesⅠ-Ⅱ,lymph node metastasis and non-lymph node metastasis,cell differentiation G3 and cell differentiation G1-G2（P〈0.05）.CONCLUSION：Survivin,Cox-2 expression increased malignant behaviors of NSCLC,with substantial correlation confirmed between Survivin and Cox-2.