黏蛋白1与结直肠癌患者预后及临床病理特征相关性的meta分析

Correlation of mucin 1 expression with prognosis and clinicopathologic characteristics in patients with colorectal cancer:a meta-analysis

目的系统评价黏蛋白1(MUC1)表达对结直肠癌患者预后的影响及其与临床病理特征的关系。方法检索从建库至2020年12月在PubMed、Embase、Web of Science、Cochrane Library、中国知网、中国生物医学文献、万方、维普等数据库公开发表的关于MUC1表达与结直肠癌患者预后关系的队列研究。两位研究者根据纳入和排除标准对文献进行筛选并提取相关数据,采用Stata 12.0软件进行meta分析。结果本研究共纳入17篇文献共2516例结直肠癌患者。meta分析结果显示,MUC1高表达组的生存情况差于低表达组[HR=1.51,95%CI(1.33,1.71),P<0.001],但与无病生存期无关[HR=1.39,95%CI(0.41,4.68),P=0.565]。亚组分析结果显示,无论采用何种分析方法(多变量或生存曲线)、在不同种族(黄种人或白种人)、不同样本量(≥100例或<100例)中均发现MUC1高表达与较差的总生存情况有关(P<0.05)。临床病理特征分析结果显示,MUC1表达水平在有淋巴结和远处转移、浸润深度达T3~4期、TNM分期为Ⅲ~Ⅳ期的结直肠癌患者中明显高于无淋巴结和远处转移者、浸润深度T1~2期者及TNM分期Ⅰ~Ⅱ期者(P<0.05),其与患者性别、年龄、肿瘤分化程度和肿瘤位置无关(P>0.05)。结论MUC1高表达与结直肠癌患者不良预后及结直肠癌淋巴结转移、远处转移、肿瘤浸润深度和TNM分期密切相关,有望作为结直肠癌病情监测及预后判断的一项参考指标。

Objective To systematically evaluate the effect of mucin 1(MUC1)expression on the prognosis and clinicopathologic characteristics of patients with colorectal cancer.Methods The cohort studies on the relationship between MUC1 expression and the prognosis of colorectal cancer patients were retrieved from PubMed,Embase,Web of Science,Cochrane Library,CNKI,China Biology Medicine,WanFang,VIP,and other databases from the establishment of the database to December 2020.The two researchers screened the literatures according to the inclusion and exclusion criteria,extracted relevant data,and performed meta analysis using Stata 12.0 software.Results A total of 17 eligible studies comprising 2516 patients with colorectal cancer were included.The results of meta-analysis showed that the overall survival(OS)of patients with high MUC1 expression was worse than that with low MUC1 expression[HR=1.51,95%CI(1.33,1.71),P<0.001],but not statistically significant with disease-free survival[HR=1.39,95%CI(0.41,4.68),P=0.565].Subgroup analysis results showed the same results as the overall analysis regardless of analysis method(multivariate or survival curve),different ethnic groups(Asian or Caucasian),and different sample sizes(≥100 or<100).The results of clinicopathologic analysis showed that the high expression of MUC1 was correlated with lymph node metastasis,distant metastasis,depth of invasion,and TNM stage(P<0.05),but not correlated with gender,age,degree of tumor differentiation,and tumor location(P>0.05).Conclusions High expression of MUC1 is closely associated with poor prognosis,lymph node metastasis,distant metastasis,tumor invasion depth,and TNM stage in patients with colorectal cancer,which is expected to be an important reference indicator for disease monitoring and prognosis judgment of colorectal cancer.