纤维蛋白原与乳腺癌患者预后关系的Meta分析

Relationship between fibrinogen and prognosis of breast cancer patients:A Meta-analysis

目的:采用Meta分析方法探讨纤维蛋白原(Fib)表达水平与乳腺癌患者预后的关系,为乳腺癌患者预后判断提供循证医学依据。方法:检索PubMed、EMbase、Cochrane图书馆和中国知网(CNKI)等数据库有关Fib与乳腺癌患者预后关系的研究,检索时限均为建库至2019年1月。由2名研究员按纳入和排除标准进行数据提取,使用STATA14.0软件对数据进行Meta分析。结果:最终纳入8篇病例对照研究,共158204例患者。纳入研究的异质性检验,I2=58.4%,P=0.019,故采用随机效应模型进行分析。Fib高表达水平与乳腺癌患者低总生存期(OS)有关[相对风险比(HR)=1.37,95%置信区间(CI):1.14,1.64,Z=3.36,P=0.001];Fib高表达水平与亚洲组乳腺癌患者低OS有关(HR=1.83,95%CI:1.23,2.72,Z=3.00,P=0.003)。敏感性分析,纳入8项研究结果稳定可信;Begg’s检验,Z=1.61,P=0.108,无明显的发表偏倚。结论:高表达水平的Fib与乳腺癌患者预后不良明显关联。

Objective : To investigate the relationship between the expression level of fibrinogen (Fib) and the prognosis of breast cancer patients with Meta-analysis, and to provide evidence-based medical evidence for the judgement of prognosis of the breast cancer patients. Methods :PubMed, EMbase, Cochrane Library and CNKI databases were searched for collecting the studies about the relationship between Fib and prognosis of the breast cancer patients from inception to January 2019. Two reviewers extracted the data according to inclusion and exclusion criteria. Meta-analysis was performed by using Stata 14.0 software. Results : A total of 158 204 patients from 8 case-control studies were included.The heterogeneity test results included in the studies were I 2=58.4%, P =0.019, and the data were analyzed using a random effect model. The results suggested that high expression level of Fib was associated with the lower overall survival (OS) in the breast cancer patients(HR=1.37, 95%CI: 1.14,1.64 , Z =3.36, P =0.001).The high expression level of Fib was associated with the lower OS in the Asia breast cancer patients( HR=1.83, 95%CI:1.23,2.72, Z =3.00, P =0.003).The sensitivity analysis results showed that the results of 8 included studies were stable and reliable;Begg’ s test, Z =1.61, P =0.108, suggesting that there was no obvious publication bias. Conclusion : High expression level of Fib is significantly associated with the poor prognosis in the breast cancer patients.