Gli1表达与肝癌临床特征和预后相关性的Meta分析

Correlation of Gli1 expression with clinical characteristics and prognosis of liver cancer:a Meta-analysis

目的探究Gli1表达与肝癌临床特征及预后的相关性。方法全面检索Pub Med、Embase、中国知网、万方数据资源系统和中国生物医学文献数据库,收集从建库至2016年12月公开发表的关于Gli1的表达与肝癌临床特征及预后相关的文献,对符合纳入标准的临床研究进行质量评价和资料提取后,采用Stata 12.0软件进行Meta分析。结果纳入12项研究,831例肝癌患者,分析显示Gli1高表达与肿瘤直径>5 cm[相对危险度(relative risk,RR)=1.39,95%置信区间(confidence interval,CI)(1.08,1.79)]、临床分期[RR=1.26,95%CI(1.05,1.51)]、肝内转移[RR=1.39,95%CI(1.06,1.83)]及血管侵犯[RR=1.44,95%CI(1.01,2.04)]存在相关性;而与性别、组织学分级、肿瘤直径>3 cm、乙型肝炎病毒感染、肝硬化、甲胎蛋白水平无明显相关。同时,Gli1高表达的肝癌患者3年/5年生存率及总生存率较低表达患者差[3年:RR=3.38,95%CI(2.01,5.67);5年:RR=1.51,95%CI(1.19,1.91);总生存率:RR=1.60,95%CI(1.11,2.30)]。此外,Gli1高表达的肝癌患者无病生存率也较低表达患者更差[RR=1.89,95%CI(1.35,2.66)]。结论 Gli1高表达与肝癌不良预后相关,可作为肝癌患者的一个预后指标。

Objective To explore the correlation of Glil expression with clinical characteristics and prognosis of liver cancer. Methods Such Databases as PubMed, Embase, CNKI, Wanfang Database and Chinese Biomedical Literature Database were searched to collect cohort studies, which has published on the correlation between the expression of Glil and the clinical pathologic features of liver cancer and its prognostic value from the establishment of the databases to December 2016. Results Twelve studies with a total of 831 patients were included in this study. The high expression of Glil was associated with the tumor diameter 〉5 cm [relative risk （RR）=1.39, 95% confidence interval （CI） （1.08, 1.79）], clinical stage [RR=1.26, 95%CI （1.05, 1.51）], intrahepatic metastasis [RR=1.39, 95%CI （1.06, 1.83）] and venous invasion [RR=1.44, 95%CI （1.01, 2.04）], but the correlation of Glil expression was not significant with gender, histological differentiation, tumor diameter 〉3 cm, hepatitis B virus, cirrhosis and alpha fetoprotein. Meanwhile, the results of Meta- analysis showed that the higher Glil expression in liver cancer patients had a worse 3-/5-year overall survival rate and overall survival rate than those of the lower Glil expression group [3-year, RR=3.38, 95%CI （2.01, 5.67）; 5-year, RR=I.51, 95%CI （1.19, 1.91）; overall survival, RR=I.60, 95%CI （1.11, 2.30）]. And the higher Glil expression in liver cancer patients had a worse disease free survival rate than that in the lower Glil expression group [RR=1.89, 95%CI （1.35, 2.66）]. Conclusion The high expression of Glil is associated with poor prognostic outcome in liver cancer, and may be used as an important prognostic marker for patients with liver cancer.