Notch1信号通路与甲状腺乳头状癌淋巴结及远处转移的相关性:Meta分析

Association of Notch1 signal pathway with lymph node and distant metastases of papillary thyroid carcinoma:a Meta analysis

目的:通过Meta分析探讨Notch1表达与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)淋巴结转移及远处转移的关系。方法:计算机检索PubMed(MEDLINE)、Cochrane Library、EMBASE、中国期刊全文数据库和中国生物医学文献数据库,辅以文献追溯,收集2010—2017年发表的关于Notch1信号通路与PTC淋巴结转移及远处转移之间关系的一次性文献。由2名研究人员各自按照文献纳入及排除标准筛选文献,提取数据,并进行文献质量评价。应用RevMan 5.3及STATA12.0软件对原始资料进行Meta分析,计算合并比值比(odds ratio,OR)及95%可信区间(condence interval,CI),并进行敏感性分析和发表偏倚检测。结果:共纳入7项临床病例-对照研究,包含743例PTC患者。Meta分析结果显示,Notch1表达与PTC淋巴结转移呈明显正相关性(OR=4.68,95%CI为3.00~7.30;合并效应量检验,Z=6.80,P<0.000 01),而与PTC远处转移无明显相关性(OR=1.59,95%CI为0.88~2.89;合并效应量检验,Z=1.53,P=0.13)。结论:Notch1信号通路在PTC淋巴结转移过程中发挥促进作用,提示Notch1表达对PTC临床预后有一定的预测价值。

Objective： To analyze the associations of Notch1 expression with the lymph node metastasis and distant metastasis of papillary thyroid carcinoma （PTC） by Meta analysis. Methods： Computer retrieve was conducted in PubMed （MEDLINE）, Cochrane Library, EMBASE, China Journal Full-text Database （CNKI）, China Biology Medicine disc （CBMdisc） to search the studies which were about the association of Notch1 signal with the lymph node and distant metastases of PTC, and published from 2010 to 201 7. The literatures were screened and evaluated, then the information was extracted independently by 2 researchers according to the literature selection criteria. Meta analysis was performed using RevMan 5.3 and STATA 12.0 software. The odds ratio （OR） and 95% confidence interval （CI） were calculated. The sensitivity analysis and publication bias test were performed. Results： A total of 7 clinical case-control studies involving 743 patients with PTC were selected. Meta-analysis showed that the expression of Notch1 was significantly positively correlated with lymph node metastasis of PTC （OR = 4.68, 95% CI： 3.00-7.30）, furthermore the test for overall effect showed that Z = 6.80 and P 〈 0.000 01. However, there was no significant correlation between Notch1 expression and the distant metastasis of PTC （OR = 1.59, 95% CI： 0.88-2.89）, the test for overall effect showed that Z and P values were 1.53 and 0.13 respectively. Conclusion： The Notch1 signaling pathway plays a promoting role in the lymph node metastasis of PTC, which suggests that the expression of Notch1 has a certain predictive value for the clinical prognosis of PTC.