非小细胞肺癌患者BRCA1表达与铂类化疗疗效的Meta分析

Meta- analysis of the effect of BRCA1 expression on the therapeutic of platinum- based chemotherapy for non- small cell lung cancer patients

目的:探讨非小细胞肺癌(NSCLC)患者乳腺癌易感基因1(BRCA1)的表达水平与铂类化疗疗效的相关性。方法:计算机检索中国知网(CNKI)数据库、万方数据库、PubMed、EMBASE和ASCO数据库。纳入的文献均为公开发表的全文文献,所有数据均从原文获得。收集关于接受铂类化疗方案的NSCLC患者BRCA1的表达水平(高表达/阳性与低表达/阴性)与化疗反应率的文章。采用Cochrane协作网RevMan 5.2软件进行Meta分析。结果:最终纳入15项研究,共1273例患者。其中BRCA1高表达/阳性患者720例,铂类化疗有效患者243例,总有效率33.75%。BRCA1低表达/阴性患者553例,铂类化疗有效患者244例,总有效率44.12%。异质性检验结果显示各研究不存在统计学异质性(P=0.03,I2=45%),采用固定效应模型对文献进行综合定量分析,合并OR值为0.63,95%CI为0.50-0.80,Z=4.09,P<0.0001。结论:在NSCLC患者中,BRCA1低表达/阴性者接受铂类化疗的疗效优于BRCA1高表达/阳性者。

To present a met analysis on the correlation between the expression of breast cancer suscep-tibility gene 1（BRCA1）and platinum - based chemotherapy for non - small cell lung cancer（NSCLC）patients. Methods：We electronically searched Chinese and English publications from the CNKI,WANFANG,PubMed,EM-BASE,and ASCO database. Inclusion criteria were NSCLC patients received platinum - based chemotherapy evalua-tion of BRCA1 expression level（high expression/ positive and low expression/ negative）and overall response rate. Meta - analysis was conducted by the Cochrane Collaboration＇s RevMan 5. 2 software. Results：Finally identified 15 studies with a total of 1273 patients. The number of patients with high/ positive BRCA1 expression was 720,and the response rate to platinum - based chemotherapy was 33. 75% . The number of patients with low/ negative BRCA1 ex-pression was 553,and the response rate to platinum - based chemotherapy was 44. 12% . Heterogeneity test showed no statistical heterogeneity among studies（P = 0. 03,I2 = 45% ）. The fixed effect model was adopted for a comprehensive quantitative analysis of the studies,and it showed that the combined odds ratio（OR）was 0. 59,with a 95% confi-dence interval of 0. 46 to 0. 76,Z = 4. 09,P ﹤ 0. 0001. Conclusion：The patients with low/ negative BRCA1 expression in NSCLC were more sensitive to platinum - based chemotherapy compared with patients with high/ positive BRCA1 expression.