lncRNA NEAT1与消化系统恶性肿瘤预后及临床病理特征关系的Meta分析

Meta-analysis of the association of lnc RNA NEAT1 with prognosis and clinicopathologic features of digestive system malignant tumors

背景与目的:长链非编码RNA核富集转录本1(lncRNA NEAT1)在多种实体肿瘤中表达失调并与不良预后密切相关,但其与消化系统恶性肿瘤患者预后之间关系仍不明确。因此,本研究通过系统评价及Meta分析探讨lncRNA NEAT1对消化系统恶性肿瘤患者预后的影响及其与临床病理特征之间的关系。方法:在线检索PubMed、Web of Science、Cochrane Library、中国知网和万方数据库,检索时间均从建库至2021年10月18日,收集公开发表的关于lncRNA NEAT1表达与消化系统恶性肿瘤患者预后或临床病理特征之间关系的队列研究,由2名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软件进行统计学分析。结果:最终共纳入20项研究,2031例消化系统恶性肿瘤患者。纳入研究的NOS评分均在6~9分之间,其中16项研究报道了总体生存率(OS),5项研究报道了无病生存率(DFS),19项研究报道了临床病理学特征。Meta分析结果显示:NEAT1高表达的消化系统恶性肿瘤患者OS(HR=1.66,95%CI=1.41~1.97,P<0.001)和DFS(HR=2.0,95%CI=1.51~2.65,P<0.001)均低于NEAT1低表达或不表达患者。根据生存分析方法、NEAT1表达截取值、样本量和随访时间进行亚组分析结果显示,NEAT1高表达患者的OS均明显降低(均P<0.05)。此外,临床病理特征分析结果显示:较高水平的NEAT1患者的肿瘤直径更大(OR=2.20,95%CI=1.73~2.79,P<0.001)、临床分期更晚(OR=3.10,95%CI=1.95~4.92,P<0.001)、淋巴结转移(OR=1.94,95%CI=1.30~2.90,P=0.001)及远处转移的风险更高(OR=2.58,95%CI=1.88~3.54,P<0.001),其与患者年龄、性别、肿瘤分化程度及脉管浸润之间无明显关系(均P>0.05)。结论:lncRNA NEAT1高表达是消化系统恶性肿瘤的不利预后因素,且与不良临床病理特征密切相关,有望作为消化系统恶性肿瘤病情监测及预后判断的重要参考指标。

Background and Aims:Long non-coding RNA nuclear-enriched transcript 1(lnc RNA NEAT1) is dysregulated in a variety of solid tumors and closely related to poor prognosis,but its relationship with the prognosis of patients with digestive system malignancies is still not clear.Therefore,this study was conducted to investigate the effect of lnc RNA NEAT1 on the prognosis of patients with malignant tumors of the digestive system and its relationship with clinicopathologic features by systematic review and Meta-analysis.Methods:The published cohort studies on the relationship between lnc RNA NEAT1 expression and the prognosis or clinicopathologic characteristics of patients with digestive system malignancies were collected by searching the Pub Med,Web of Science,Cochrane Library,China Knowledge Infrastructure and Wanfang databases.The search period was from the inception of the databases to 18 th October 2021.Literature screening was performed by two investigators according to the inclusion and exclusion criteria,and the relevant data were extracted.Stata 12.0 software was used for statistical analysis.Results:A total of 20 studies involving 2 031 patients with malignant tumors of the digestive system were finally included.The NOS scores of the included studies ranged from 6 to 9,of which 16 studies reported overall survival(OS),5 studies reported disease-free survival(DFS),and 19 studies reported clinicopathologic features.Meta-analysis revealed that the OS(HR=1.66,95% CI=1.41-1.97,P0.05).Conclusion:The high expression of lnc RNA RNA NEAT1 is an adverse prognostic factor for malignant tumors of the digestive system,and is also closely associated with unfavorable clinicopathologic features,which may be used as an important reference index for monitoring the condition and prognosis of malignant tumors of the digestive system.