CD133在胃癌組織中的表達(dá)及其臨床意義的系統(tǒng)評價
發(fā)布時間:2018-07-08 08:56
本文選題:胃癌 + CD133; 參考:《蘭州大學(xué)》2015年碩士論文
【摘要】:目的全面收集國內(nèi)外發(fā)表的相關(guān)研究,系統(tǒng)評價CD133蛋白表達(dá)與胃癌及其臨床病理學(xué)特征之間的關(guān)系,以了解CD133在胃癌發(fā)生、發(fā)展過程中的作用,以期為胃癌的治療和預(yù)后干預(yù)提供循證醫(yī)學(xué)依據(jù)。方法計算機(jī)檢索中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、中文科技期刊全文數(shù)據(jù)庫、相關(guān)期刊論文、萬方數(shù)據(jù)庫、PubMed、EMbase、Web of Knowledge和The Cochrane Library,均從建庫檢索至2013年10月;并輔以手工檢索,查找國內(nèi)外公開發(fā)表的關(guān)于CD133蛋白表達(dá)與胃癌及其臨床病理特征相關(guān)性的病例-對照研究。由兩位研究者按照事先制定的納入排除標(biāo)準(zhǔn)篩選文獻(xiàn)、提取資料并評價方法學(xué)質(zhì)量后,采用RevMan 5.2軟件進(jìn)行Meta分析。使用STATA 11.0進(jìn)行Begg和Egger檢驗(yàn),并繪制Begg圖和Egger圖。最后,使用GRADEpro 3.6對各結(jié)果指標(biāo)進(jìn)行證據(jù)質(zhì)量分級。結(jié)果最終納入9個病例-對照研究,共623例患者。Meta分析結(jié)果顯示:CD133蛋白在胃癌組與癌旁和正常胃組織組[OR=3.89,95%CI (1.87,8.11),P=0.0003]、淋巴結(jié)轉(zhuǎn)移組與無淋巴結(jié)轉(zhuǎn)移組[OR=2.75,95%CI (1.99,3.81),P0.00001]、胃癌Ⅲ~Ⅳ期組與Ⅰ-Ⅱ期組[OR=2.83,95%CI (2.13,3.76),P0.00001]、伴遠(yuǎn)處轉(zhuǎn)移組與無遠(yuǎn)處轉(zhuǎn)移組[OR=2.38,95%CI (1.47,3.85),P=0.0004]的表達(dá)差異均有統(tǒng)計學(xué)意義。在高中分化組與低分化組的表達(dá)差異無統(tǒng)計學(xué)意義[OR=1.70,95%CI (0.90,3.21),p=0.10],但敏感性分析結(jié)果顯示該指標(biāo)Meta分析結(jié)果不穩(wěn)定,其他結(jié)果穩(wěn)定。發(fā)表偏倚檢測結(jié)果顯示本系統(tǒng)評價不存在發(fā)表偏倚。證據(jù)質(zhì)量分級結(jié)果顯示3個結(jié)果指標(biāo)為中等質(zhì)量,2個指標(biāo)為低質(zhì)量。結(jié)論CD133蛋白在胃癌組織中的表達(dá)比癌旁組織及正常胃組織高,而且其表達(dá)與淋巴結(jié)轉(zhuǎn)移、遠(yuǎn)處轉(zhuǎn)移及臨床分期等明顯相關(guān),說明CD133可能在胃癌發(fā)生、發(fā)展過程中起重要作用。上述結(jié)論尚需更多大樣本、設(shè)計嚴(yán)謹(jǐn)?shù)母哔|(zhì)量研究加以驗(yàn)證。
[Abstract]:Objective to investigate the relationship between CD133 protein expression and gastric cancer and its clinicopathological features in order to understand the role of CD133 in the carcinogenesis and development of gastric cancer. In order to provide evidence-based medicine basis for the treatment and prognosis intervention of gastric cancer. Methods Chinese biomedical literature database, Chinese scientific and technological journal full-text database, Chinese journal full-text database, Wanfang database were searched by computer from the construction of the database to October 2013, and the database was retrieved by hand. A case-control study on the correlation between CD133 protein expression and gastric cancer and its clinicopathological features was studied. After the two researchers sifted the literature according to the pre-established exclusion criteria, extracted the data and evaluated the quality of methodology, the Meta-analysis was carried out with Revman 5.2 software. Stata 11.0 was used to test Begg and Egger, and Begg and Egger were drawn. Finally, gradepro 3.6 was used to classify the quality of evidence. The results were eventually included in 9 case-control studies, Meta-analysis of 623 patients showed that the proportion of CD133 protein was present in gastric cancer group, paracancerous group and normal gastric tissue group [OR3.899 995 CI (1.87 鹵8.11) P0. 0003], lymph node metastasis group and non lymph node metastasis group [OR2. 755 + 95 CI (1. 993. 81) P 0. 00001], gastric cancer stage 鈪,
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