磷酸化p70核糖体蛋白S6激酶在肺癌组织中表达及临床意义的系统评价

A Systematic Review of Phospho-p70 Ribosomal Protein S6 Kinase Expression and Its Clinical Significance in Lung Cancer

目的系统评价磷酸化p70核糖体蛋白S6激酶（p-p70S6K）这一肿瘤相关标志物在肺癌中的表达情况及临床意义。方法计算机检索Medline、EMbase、中国生物医学文献数据库、中国期刊全文数据库、维普等数据库收集有关p-p70S6K在肺癌中表达及临床意义的研究,检索时限为建库至2014年2月4日。按照纳入排除标准筛选文献,提取资料,进行数据分析。结果纳入8个研究共953例患者。p-p70S6K在非小细胞肺癌（NSCLC）组织中的阳性表达率波动于41%~70%,在小细胞肺癌组织中的阳性表达率波动于17%~91%。使用随机效应模型进行分析,p-p70S6K在NSCLC组织中的阳性表达率高于正常组织[OR=5.08,95%CI（2.96,8.71）,P〈0.000 01]。在低分化与中高分化的肺癌组织中,p-p70S6K的阳性表达率差异无统计学意义[OR=1.40,95%CI（0.50,3.92）,P=0.53]。p-p70S6K在有淋巴结转移及无淋巴结转移的肺癌患者中其阳性表达率差异无统计学意义[OR=1.11,95%CI（0.56,2.23）,P=0.76]。结论 p-p70S6K在NSCLC中的阳性表达率显著高于正常组织,可能与肺癌的发生发展相关,但需进一步研究证实。

Objective To systematically evaluate the expression and clinical features of phospho-p70 ribosomal protein S6 kinase （p-p70S6K） in lung cancer. Methods We systematically searched the published researches about p-p70S6K expression and clinical features of lung cancer in Medline, EMbase, Chinese BioMedical Literature, China National Knowledge Infrastructure and WeiPu databases from their establishment to February 4th, 2014. According to the inclusion and exclusion criteria, the data were extracted and the Cochrane Review Manager 5 and Stata 12.0 were used for data analysis. Results Eight studies including 953 patients were included in this systematic review. Analysis with random effects model showed that the positive expression rate of p-p70S6K in non-small cell lung cancer （NSCLC） tissues spread from 41% to 70%. In small cell lung cancer tissues, the positive expression rate of p-p70S6K ranged from 17% to 91%. The positive expression rate of p-p70S6K in NSCLC was significantly higher than adjacent normal tissues [OR=5.08, 95%CI （2.96, 8.71）, P 〈 0.000 01 ]. Divided by status of cell differentiation, the positive expression rate of p-p70S6K between low differentiation and moderate-high differentiation groups had no statistically significant difference [OR=1.40, 95%CI （0.50, 3.92）, P=-0.53]. In addition, the positive expression rate of p-p70S6K was not related to lymph node metastasis [OR=I. 11, 95%CI （0.56, 2.23）,/）=-0.76]. Conclusions Compared with adjacent normal tissues, positive expression rate ofp-p70S6K in NSCLC is significantly higher, indicating that p-p70S6K may be associated with the development of lung cancer. The positive expression rate ofp-p70S6K in different kinds of lung cancer is still unclear, which needs further studies to explore.