pSTAT3过表达与肺癌预后相关性的Meta分析

Correlation of pSTAT3 overexpression and prognosis in lung cancer patients:a meta-analysis

目的系统评价p STAT3过表达与肺癌预后的相关性。方法计算机检索Pub Med、EMbase、Web of Science、CNKI、VIP和Wan Fang Data等数据库,搜集关于p STAT3过表达与肺癌预后的相关研究,检索时限均为建库至2016年11月。由2位评价者独立进行文献筛选、资料提取和评价偏倚风险后,采用Rev Man 5.2软件进行Meta分析。结果最终纳入13个研究。Meta分析结果显示:p STAT3过表达组的肺癌患者总生存率明显低于p STAT3低表达组[HR=1.23,95%CI(1.04,1.46),P=0.02];临床预后特征方面,肺癌患者Ⅲ~Ⅳ期组的p STAT3过表达阳性率明显高于Ⅰ~Ⅱ期组[OR=1.92,95%CI(1.13,3.27),P=0.02],肺癌伴淋巴结转移组的p STAT3过表达阳性率明显高于不伴淋巴结转移组[OR=1.81,95%CI(1.20,2.72),P=0.004],两组差异均有统计学意义。但p STAT3过表达在肺癌高中分化组和低分化组[OR=0.82,95%CI(0.44,1.53),P=0.54]的差异无统计学意义。结论 p STAT3过表达的肺癌患者总生存率较差,且TNM分期更晚和淋巴结转移率更高,可能是预后不良的指征。受纳入研究数量和质量的限制,上述结论尚待开展更多高质量研究予以验证。

Objective To systematically review the correlation ofpSTAT3 overexpression and prognosis in lung cancer patients. Methods We searched from PubMed, EMbase, Web of Science, CNKI, VIP and WanFang Data databases to collect relevant studies about the correlation of pSTAT3 overexpression and prognosis in lung cancer patients from inception to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.2 software. Results A total of thirteen studies were enrolled. The results of the meta-analysis showed that the overall survival （HR= 1.23, 95%CI 1.04 to 1.46, P=0.02） of pSTAT3 overexpression group was shorter than that of low expression group. In terms of clinical prognostic characteristics, pSTAT3 overexpression rate in stage HI to IV group was significantly higher than stage I to II （OR=1.92, 95%CI 1.13 to 3.27, P=0.02）. pSTAT3 overexpression rate of lung cancer patients with lymphatic node metastasis was also significantly higher than lung cancer patients without lymphatic node metastasis （OR= 1.81, 95%CI 1.20 to 2.72, P=0.004）. However, there was no statistical difference ofpSTAT3 overexpression between well-moderately differentiation and poorly differentiation group （OR=0.82, 95%CI 0.44 to 1.53, P=0.54）. Conclusion pSTAT3 overexpression is associated with poorer overall survival of lung cancer patients, as well as with more and advanced TNM grade and lymph node metastasis. It may be an indicator poor biomarker in lung cancer patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.