XPD基因多态性与晚期非小细胞肺癌患者铂类化疗获益的Meta分析

Association of XPD Lys751Gln with Clinical Outcome of PlatinumBased Chemotherapy in Advanced Non-Small Cell Lung Cancer:A Meta-Analysis

目的采用Meta分析的方法评价XPD基因多态性与晚期非小细胞肺癌患者铂类化疗获益的关系，为临床用药和个体化治疗提供参考。方法计算机检索PubMed、CNKI、CBM和万方中文数据库，按照制订的纳入与排除标准筛选关于XPD基因多态性与晚期非小细胞肺癌患者铂类化疗获益相关性的病例对照研究或者队列研究．检索时限为数据库建库至2012年9月。获得所需的数据、评价纳入研究方法学质量，使用RevMan5．4．1进行统计分析。结果共纳入文献15篇，文献质量评价结果显示纳入研究质量良好。Meta分析发现：①野生型Lvs／Lvs患者与突变型Lys／Gln及Gln／Gln患者的铂类化疗敏感性没有显著性差异，合并优势比为1．26（95％可信区间0．96—1．66）。②野生型LYs／Lys患者与突变型Lys／Gln及Gln／Gln患者生存风险比没有显著性差异，合并风险比值为1．06（95％可信区间0．81—1．37）。③以人种分组的亚组分析发现XPDLys751Gin多态性在不同人种中与患者接受铂类药物的远期获益无关。结论XPDLys751Gln与晚期非小细胞肺癌患者对铂类药物化疗获益无关。但因为纳入研究的数量有限，仍应开展更多高质量、大样本的随机对照试验加以验证。

Objective To evaluate the association between XPD Lys751Gln and the clinical outcome of platinum- based chemotherapy in advanced NSCLC and guide the clinical medication and individualized treatment. Methods A meta-analysis was used to analyze the association between XPD Lys751Gln and the clinical outcome in advanced NSCLC patients treated with platinum-based chemotherapy. Results A total of 15 case-control studies were included in the meta-analysis. The result showed no associations between XPD Lys751Gln and the clinical outcome of platinum- based chemotherapy in advanced NSCLC patients. The pooled OR values for Lys/Gln＋Gln/Gln compared with Lys/Lys was 1.26 （95%CI 0.96-1.66）. The pooled HR for death in patients with Lys/Gln＋Gln/Gln was 1.06 （95%CI 0.81- 1.37）. In the subgroup analysis by ethnicity, no statistically differences were found between XPD Lys751Gln and survival in advanced NSCLC patients treated with platinum-based chemotheray. Conclusion The result of meta- analysis suggests that no association between XPD Lys751Gln and the clinical outcome of platinum-based chemotherapy in advanced NSCLC. Further studies are needed to validate the conclusion.