HER2扩增与结直肠癌患者临床病理特征和预后相关性的meta分析

Correlation of human epidermal growth factor receptor 2 amplification with clinicopathological characteristics and prognosis of colorectal cancer patients:a metaanalysis

目的系统评价人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)扩增与结直肠癌患者临床病理特征和预后的相关性。方法对PubMed、EMbase、Cochrane Library、中国生物医学文献数据库(CBM)、万方等数据库进行检索,纳入探索HER2扩增与结直肠癌患者临床病理特征与预后关系的队列研究。检索时限均从建库至2020年10月,采用RevMan 5.4软件进行meta分析。结果最终纳入9项研究(11个队列)进行meta分析,共计7209例结直肠癌患者。meta分析结果显示,HER2扩增与总生存期[HR=1.10,95%CI(0.98,1.24),P=0.11]无关;HER2扩增与性别[OR=0.98,95%C1(0.74,1.31),P=0.90]和肿瘤分化程度[OR=0.80,95%C1(0.49,1.32),P=0.39]无关,与肿瘤部位[OR=1.85,95%C1(1.01,3.37),P=0.04]、RAS野生型[OR=6.36,95%C1(3.41,11.87),P<0.00001]、TNM分期[OR=0.45,95%C1(0.32,0.64),P<0.00001]、淋巴结转移[OR=1.54,95%C1(1.12,2.13),P=0.008]和肿瘤浸润深度[OR=0.17,95%C1(0.05,0.55),P=0.003]相关。结论当前证据表明,HER2扩增与结直肠癌患者的OS无关,与肿瘤部位、RAS基因型、淋巴结转移、TNM分期和肿瘤浸润深度相关。

Objective To systematically evaluate the correlation of amplification of human epidermal growth factor receptor 2(HER2)with the clinicopathological characteristics and prognosis of colorectal cancer patients.Methods PubMed,EMbase,Cochrane Library,Chinese Biomedical Literature Database(CBM),Wanfang,and other databases were searched,and cohort studies focused on the relationship between HER2 amplification and clinicopathological characteristics and prognosis of colorectal cancer patients were included.The retrieval time limit was from October 2020,and RevMan 5.4 software was used for meta-analysis.Results A total of 9 studies(11 cohorts)were included for meta-analysis of 7209 patients with colorectal cancer.Results of the meta-analysis showed that HER2 amplification was not associated with overall survival[HR=1.10,95%CI(0.98,1.24),P=0.11].HER2 amplification was not correlated with gender[OR=0.98,95%C1(0.74,1.31),P=0.90]and tumor differentiation[OR=0.80,95%C1(0.49,1.32),P=0.39],but correlated with the tumor location[OR=1.85,95%C1(1.01,3.37),P=0.04],RAS wild-type gene[OR=6.36,95%C1(3.41,11.87),P<0.00001],TNM stage[OR=0.45,95%C1(0.32,0.64),P<0.00001],lymph node metastasis[OR=1.54,95%C1(1.12,2.13),P=0.008],and the depth of tumor invasion[OR=0.17,95%C1(0.05,0.55),P=0.003].Conclusion Current evidence shows that HER2 amplification is not associated with OS in patients with colorectal cancer,but associated with tumor infiltration,lymph node metastasis,TNM stage,tumor site,and RAS genotype.