乳腺癌组织中Cx43表达水平及其临床意义的Meta分析

Meta-analysis of Cx43 expression and clinical significance in breast cancer tissues

目的 Cx43被发现与多种恶性肿瘤相关,但在评估乳腺癌预后及临床病理意义上的价值尚存在争议,该研究通过采集国内外有关文献并对Cx43和乳腺癌的关系进行系统评价。方法计算机检索Pub Med、Embase、Web of Science、循证医学数据库、中国知网及万方数据库,并加以文献追溯的手段收集整理大量乳腺癌组织中Cx43表达及其临床病理特征相关的患者进行对照研究,检索时限从建库至2017年4月。根据纳入与排除准则对文献制定挑选并采用纽卡斯尔渥太华量表对文献进行质量评价,采用Review Manager 5.3软件对数据进行Meta分析。结果该研究共纳入14篇文献对照研究,其中乳腺癌组织标本有632例,正常乳腺组织标本有240例,乳腺增生组织标本有167例。Meta分析结果显示:(1)Cx43在乳腺癌组织的阳性表达率低于正常乳腺组织(P<0.05);(2)Cx43在乳腺癌组织中阳性表达率低于乳腺增生组织(P<0.05);(3)乳腺癌TNMⅢ、Ⅳ期中Cx43的阳性表达率低于TNMⅠ、Ⅱ期(P<0.05);(4)Cx43在乳腺癌组织学分级Ⅲ级中的阳性表达率低于组织学分级Ⅰ、Ⅱ级(P<0.05);(5)Cx43在有淋巴结转移的乳腺癌组织中的阳性表达率与无淋巴结转移无差异(P>0.05)。结论目前研究证明,Cx43与乳腺癌的各项临床特征有密切联系,参与了乳腺癌的进展。

Objective To systematically evaluate the relationship between Cx43 and breast cancer by collecting relevant literature at home and abroad.Methods Through computer retrieval of PubMed,Embase,Web of Science,DynaMed,CNKI,and WANFANG Data six databases,together with the means of literature tracing,Cx43 expression in a large number of breast cancer tissues and the clinicopathological characteristics of the patients were collected for the case-control study,The search period was from the building of the databases to April 2017.The literature was selected according to the inclusion and exclusion criteria and the NOS scale was used to evaluate the quality of the literature,and the data were then analyzed using Review Manager 5.3 software.Results A total of 14 case-control studies were included in the study.There were 632 cases of breast cancer specimens,240 cases of normal breast tissue specimens and 167 cases of mammary hyperplasia tissues.Meta-analysis showed that the positive expression rate of Cx43 in the breast cancer tissues was significantly lower than that in the normal breast tissue and the breast hyperplasia tissues(P<0.05),the positive rate of Cx43 expression in the breast cancers of TNM stage III and IV was significantly lower than that in the breast cancers of TNM stage I and II(P<0.05),the positive expression rate of Cx43 in the histological grade III of breast cancers was significantly lower than that in the histological grade I and II(P<0.05),and the positive expression rate of Cx43 in the breast cancers with lymph node metastasis was not significantly different from that in the breast cancers without lymph node metastasis(P>0.05).Conclusions Current studies have shown that Cx43 expression is closely associated with the clinical characteristics of breast cancers,but because of the small number of cases,more high-quality studies are needed to confirm that.