DNA错配修复蛋白表达缺失与胃癌临床病理特征相关性的meta分析

Meta-analysis of the correlation between the deficient DNA mismatch repair protein and clinicopathological features of gastric cancer

目的利用meta分析综合评价DNA错配修复蛋白表达缺失(dMMR)与胃癌临床病理特征的相关性。方法使用关键词系统检索PubMed、Web of Science、Embase数据库、知网、万方以及维普数据库中关于DNA错配修复(MMR)蛋白表达与胃癌临床病理特征的相关研究,检索从建库开始至2021年6月。依据Cochrane筛选文献及提取数据,根据纽卡斯尔-渥太华量表(NOS)评价纳入文献的质量,最后利用Review Manager 5.4.1进行meta分析。结果共纳入13项研究,5075例胃癌患者,其中dMMR患者530例,占比为10.44%。meta分析结果显示,肿瘤位置与dMMR有显著相关性(OR=0.60,95%CI=0.47~0.76,P<0.0001);劳伦分型与dMMR有显著相关性(OR=2.56,95%CI=1.49~4.39,P=0.0007);dMMR与无淋巴结转移胃癌有显著相关性(OR=1.40,95%CI=1.12~1.75,P=0.003);TNM分期与dMMR无显著相关性(OR=1.47,95%CI=0.88~2.44,P=0.14);伴有淋巴管浸润的胃癌与dMMR有显著相关性(OR=1.70,95%CI=1.23~2.36,P=0.001)。所有亚组纳入文献均不存在发表偏倚(P>0.05)。结论dMMR的胃癌患者具有显著的临床病理特征,对诊断及临床治疗具有重要的价值。

Objective To comprehensively evaluate the correlation between the deficient DNA mismatch repair protein(dMMR)and clinicopathological features of gastric cancer using meta-analysis.Methods Keywords were searched from PubMed,Web of Science,Embase database,CNKI,WanFang and VIP database for relevant studies on DNA mismatch repair(MMR)protein expression and clinicopathological features of gastric cancer from the database construction to June 2021.Cochrane was used to screen the literature and extract data,and the quality of the included literature was evaluated according to the Newcastle-Ottawa scale(NOS).Finally,meta-analysis was performed using Review Manager 5.4.1.Results A total of 13 studies were included,including 5075 gastric cancer patients,530 of whom were dMMR patients,accounting for 10.44%.Meta-analysis showed that tumor location was significantly correlated with dMMR(OR=0.60,95%CI=0.47-0.76,P<0.0001).Lauren typing was significantly correlated with dMMR(OR=2.56,95%CI=1.49-4.39,P=0.0007).dMMR was significantly correlated with gastric cancer without lymph node metastasis(OR=1.40,95%CI=1.12-1.75,P=0.003).There was no significant correlation between TNM staging and dMMR(OR=1.47,95%CI=0.88-2.44,P=0.14).dMMR was significantly associated with gastric cancer with lymphatic infiltration(OR=1.70,95%CI=1.23-2.36,P=0.001).There was no publication bias in all subgroups(P>0.05).Conclusion dMMR has significant clinicopathological features in gastric cancer patients,which is of great value for diagnosis and clinical treatment.