人脑胶质瘤中巢蛋白的表达与预后关系的Meta分析

Prognostic significance of nestin in glioma patients： a Meta-analysis

目的系统评价人脑胶质瘤中巢蛋白（nestin）的表达水平与预后的关系。方法以“nesfin、gliomaJgliomas、glioblastoma、survival、prognosis／prognostic”为关键词和限制条件检索PubMed／Medline、WebofScience、CochraneLibrary、Googlescholar等数据库收录的1990年1月至2015年5月关于人脑胶质瘤中nestin的表达水平与预后关系的文献。提取资料进行质量评价并采用R统计软件（R．3．1．3）进行Meta分析。结果筛选后纳入8篇文献，研究对象共1313人，各组数据均未见明显的发表偏倚。Meta分析显示胶质瘤中nestin的表达与患者的总生存期（0S1呈负相关[危险比率（HR）=1．64，95％可信区间（CI）为1．27-2．12，P=0．000]。胶质瘤中nesfin的表达与患者的无进展生存期（PFS）呈负相关（HR=1．54，95％cI为1．04～2．28，P=-0．030）；亚组分析显示WHO分级为0S组数据主要的异质性来源（P=-0．0015），并且WHO分级越低，nestin对总生存期的影响越显著。样本量的大小为PSF组数据异质性的主要来源（P=0．008），并且样本量越大，Nestin对无进展生存期的影响越显著。结论通过nestin表达水平的检测可准确判断患者的生存期。Nestin可作为判断胶质瘤患者预后的指标。

Objective To objectively and systematically evaluate the prognostic significance of nestin in glioma patients with Meta-analysis. Methods A systematic literature search of PubMed/Medline, Web of Science, Cochrane Library and Google scholar was performed to recruit studies between January 1990 and May 2015 that evaluated the correlation ofnestin with overall survival （OS） and progression-freesurvival （PFS） in gliomapatients. A Meta-analysis （R-3.1.3） was conductedto analyze the prognostic significance of nestin in glioma patients. Results A total of 8 studies with the total number of 1313 patients met inclusion criteria. The analysis demonstrated negative associations between nestin high expression and both poor OS （hazard ratio [HR]=1.64, 95% confidence interval [CI] =1.27-2.12, P=0.0001） and PFS （HR=l.54, 95%CI=1.04-2.28, P=-0.0301）. WHO grading was the main source of heterogeneity of OS data （P=-0.0015）, and the lower the WHO grade, the more significant the influence in OS. The sample capacity was the main source of heterogeneity of PSF data （P=0.008）, and the larger the sample capacity, the more significant the influence in PFS. Conclusion The nestin expression can be used for accurately assessing the survival of glioma patients, thus, nestin could be recommended as a useful survival biomarker in clinical practice.