CD133在胃癌组织中的表达及其临床意义的系统评价

Clinical Significance of CD133 Expression in Gastric Cancer: A Systematic Review

目的系统评价CD133蛋白表达与胃癌及其临床病理特征的相关性。方法计算机检索PubMed、EMbase、WebofKnowledge、TheCochraneLibrary（2013年第10期）、CBM、VIP（1989～2013．10）、CNKI及WanFangData，查找国内外公开发表的关于CDl33蛋白表达与胃癌及其临床病理特征相关性的病例一对照研究，检索时限均为从建库至2013年10月。由两位研究者按照纳入和排除标准筛选文献、提取资料并评价质量后，采用RevMan5．2软件进行Meta分析。结果最终纳入9个病例一对照研究，共623例患者。Meta分析结果显示：CDl33蛋白在胃癌组与癌旁和正常胃组织组[OR=3．89，95％CI（1．87，8．11），P=0．0003]、淋巴结转移组与无淋巴结转移组[OR=2．75，95％CI（1．99，3．81），P〈0．00001]、胃癌Ⅲ-Ⅳ期组与Ⅰ～Ⅱ期组[OR=2．83，95％CI（2．13，3．76），P〈0．00001]、伴远处转移组与无远处转移组[OR=2．38，95％CI（1．47，3．85），P=0．0004]的表达差异均有统计学意义。但在高中分化组与低分化组的表达差异无统计学意义[OR=I．70，95％CI（0．90，3．21），P=0．103。结论CDl33蛋白的表达与胃癌患病及其淋巴结转移、远处转移及临床分期等有明显相关性，提示其在胃癌发生、发展过程中可能起重要作用。受纳入研究质量限制，上述结论尚需更多大样本、设计严谨的高质量研究加以验证。

Objective To systematically review the expression and clinical significance of CD133 in gastric cancer. Methods Searches in the databases such as PubMed, EMbase, Web of Knowledge, The Cochrane Library （Issue 10, 2013）, CBM, VIP, CNKI and WanFang Data were performed to collect case-control studies about the association between the CD133 expression and gastric cancer up to October 2013. Two reviewers independently screened the literature ac- cording to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies, and then RevMan 5.2 software was used for meta-analysis. Results Nine case-control studies involving 623 pa- tients were included. The results of the meta-analyses showed that, there were significant differences of CD 133 expression in the following comparisons： gastric cancer tissues vs. normal esophageal tissues （OR=3.89, 95%CI 1.87 to 8.11, P=0.000 3）, lymph node metastasis vs. non-lymph node metastasis （OR=2.75, 95%CI 1.99 to 3.81, P〈0.000 01）, clinical stages Ⅲ - Ⅳvs. clinical stages Ⅰ - Ⅱ（OR=2.83, 95%CI 2.13 to 3.76, P〈0.000 01）, as well as distant metastasis vs. non-distant metastasis （OR=2.38, 95%CI 1.47 to 3.85, P=0.000 4）. While no significant difference was found between the cell differentiation G1- G2 vs. cell differentiation G3 （OR=1.70, 95%CI 0.90 to 3.21, P=0.10）. Condusion Over-expression of CD133 is associat- ed with lymph node metastasis, distant metastasis and poor TNM stage, which suggests that CD133 may participate in the carcinogenesis of gastric cancer. However, due to the limitations of the included studies, more large-sample high-quality case-control studies are still needed to verify these results.