Survivin过表达促进宫颈上皮内瘤变的meta分析

Over expression of survivin promoters the formation and progression of cervical intraepithelial neoplasia: a meta-analysis

目的系统评价肿瘤凋亡抑制蛋白Survivin过表达与宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的关系。方法以关键词"Survivin+CIN"进行计算机检索The Cochrane Library、Pub Med、Embase、Medline、CBM、CNKI、维普及万方等数据库,起自建库止于2017年7月。随后应用软件Stata12.0进行程序性操作分析。结果纳入17篇文献,共1 819例受试者,包含正常宫颈357例和CIN 1 462例(其中CINⅠ471例、CINⅡ415例、CINⅢ576例)。Survivin阳性表达率的OR值(95%CI)在CIN组/正常宫颈组为31.76(18.47,54.62),在CINⅡ组/CINⅠ组为2.92(2.15,3.96),在CINⅢ组/CINⅠ组为8.926(6.43,12.40),在CINⅢ组/CINⅡ组为3.26(2.38,4.47)。结论 Survivin过表达于CINs形成后,并随CINs级别升高而显著升高,表明Survivin过表达促进了CINs的发生和发展,所以检测Survivin的表达有助于CINs的诊断及进展型CINs的预测。

Objective To more systematically evaluate the relationship between the overexpression of Survivin one of the inhibitory protein of apoptosis and the degrees of cervical intraepithelial neoplasia（CIN）. Methods Using key words＂Survivin＋CIN＂, articles were searched in the Cochrane Library, Pub Med, Embase, Medline, CBM, CNKI,VIP and Wan Fang database. The searched period was from the inception of the databases to July 2017. The articles were then analyzed by Stata 12.0 application software. Results A total of 1 819 subjects included in 17 articles were enrolled into this study, which had 357 cases of normal cervixes and 1 462 cases of CINs（471 CIN Ⅰ, 415 CIN Ⅱ and 576 CINⅢ）. The positive rate of survivin was expressed as OR value（95% CI）： 31.76（18.47, 54.62） between the normal cervix group and the CINs group, 2.92（2.15, 3.96） between the CIN Ⅱ group and the CIN Ⅰ group, 8.926（6.43,12.40） between the CIN Ⅲ group and the CIN Ⅰ group, and 3.26（2.38, 4.47） between the CIN Ⅲ group and the CIN Ⅱ group.Conclusion The overexpression of Survivin occurs after CIN formation and increases during the rising of the CIN degrees. The results indicated that the over-expression of Survinvin promoted the formation and progression of CINs. The detection of survivin expression might aid to the diagnosis of CINs and prediction of the progressive CINs.