miR-21在食管癌中预后作用的meta分析

Prognostic role of miR-21 in esophageal cancer: a meta-analysis

目的应用循证医学的方法综合评价miR-21与食管癌(EC)预后的相关性。方法检索美国国立图书馆(Pub Med),荷兰医学文摘(EMBASE),ISI Web of Science数据库中miR-21与EC预后的文献,按照已拟定的纳入和排除标准筛选符合要求的研究。提取miR-21与EC预后相关的相应数据,并对提取的数据进行统计学描述。采用风险比(HR)、95%可信区间(CI)及P值定量评价miR-21与EC预后的相关性。结果初步检索数据库得到273篇文献,其中其中7项可用于meta分析,中位样本量为98例,四分位数间距(IQR)=70~164。中位HR值1.4,IQR=0.89~2.23。中位随访时间30个月,IQR=29.4~39个月。高表达miR-21的EC患者的预后生存率HR=1.367,95%CI=1.15~1.62,P=0.000;食管鳞癌(ESCC)亚组生存率HR=1.44,95%CI=1.2~1.72,P=0.000。高表达miR-21的食管腺癌(AD)患者亚组预后生存率HR=0.82,95%CI=0.47~1.44,P=0.489,无统计学意义。结论 miR-21作为EC患者的预后标记具有地域性和组织特异性。miR-21对于ESCC高发的中国和日本具有预测不良预后的潜力,有望成为新型的EC生物学标志物,但对AD高发的加拿大和美国则不具有相应的预测能力。

Objective To synthetically evaluate the correlation between miR-21 and the prognosis of esophageal cancer .Methods With proposed inclusion and exclusion criteria ,the electronic databases PubMed ,EMBASE and ISI Web of Science for original articles analy-sing the prognostic value of miR-21 in esophageal cancer were enrolled .Relevant data were extracted from studies investigating the relation-ship between miR-21 expression and survival in esophageal cancer patients .Descriptive characteristics for relevant data were described by the median value and interquartile range .Pooled hazard ratios ( HRs) ,95%CI and P value were used to evaluate the correlation between miR-21 expressionandsurvivalinesophagealcancer.Results 273studiesformiR-21andesophagealcancerprognosiswereidentifiedfromprimary article search in Pubmed ,Embase and Web of Science .Totally 7 articles were considered eligible for meta-analysis according to the inclusion and exclusion criteria.The median sample size was 98 patients〔interquartile range(IQR)=70~164〕,the median HR was 1.4(IQR=0.89~2.23) and the median follow up was 30 months(IQR=29.4~39 months).High expression of miR-21 was negatively correlated with survival rate in esophageal cancer patients (HR=1.367〔1.15~1.62〕,P<0.001).The pooled HR in adenocarcinoma patients with high expression of miR-21 was statistical insignificant(HR=0.82〔0.47~1.44〕,P=0.489).Conclusions miR-21 as a prognostic marker in esophageal car-cinoma patients has regional and tissue specificity .MiR-21 has the potential to predict poor prognosis with high incidence of ESCC in China and Japan ,and is expected to become a new biomarker for esophageal cancer rather than high incidence of adenocarcinoma in Canada and A -merican.