MiRNA-21的表達(dá)與結(jié)直腸癌患者術(shù)后預(yù)后關(guān)系的meta分析
發(fā)布時(shí)間：2018-07-28 13:44
【摘要】：目的:結(jié)直腸癌是常見(jiàn)的消化道惡性腫瘤之一,其預(yù)后受多方面的影響,miRNA-21在結(jié)直腸癌患者預(yù)后中的影響仍存在爭(zhēng)議,本研究主要采用循證醫(yī)學(xué)的方法通過(guò)對(duì)miRNA-21與結(jié)直腸癌患者預(yù)后之間的關(guān)系進(jìn)行meta分析,為臨床診療提供循證醫(yī)學(xué)證據(jù)。方法:按照本研究的類(lèi)型、研究對(duì)象和研究目的等制定嚴(yán)格的文獻(xiàn)納入與排除標(biāo)準(zhǔn)、詳細(xì)的檢索策略,通過(guò)計(jì)算機(jī)系統(tǒng)檢索了PubMed、EBSCO、EMBASE全文數(shù)據(jù)庫(kù)、Cochrane圖書(shū)館、Medline、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)(CNKI)、萬(wàn)方數(shù)據(jù)庫(kù)、科學(xué)引文索引數(shù)據(jù)庫(kù)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、重慶維普中文科技期刊數(shù)據(jù)庫(kù)等數(shù)據(jù)庫(kù)。檢索自該數(shù)據(jù)庫(kù)建立時(shí)間至2017年03月公開(kāi)發(fā)表的相關(guān)文獻(xiàn),為了提高查全率,我們又對(duì)所有相關(guān)參考文獻(xiàn)進(jìn)行了追蹤。納入的相關(guān)研究文獻(xiàn)經(jīng)過(guò)紐卡斯?fàn)?渥太華量表(The Newcastle-Ottawa Scale,NOS)行質(zhì)量評(píng)價(jià)后,建立Excel表格收集相關(guān)數(shù)據(jù),采用國(guó)際Cochrane協(xié)作網(wǎng)提供的Revman5.3軟件和Stata12.0軟件對(duì)所提取的數(shù)據(jù)資料進(jìn)行統(tǒng)計(jì)學(xué)分析處理,生存分析的效應(yīng)量通常采用危險(xiǎn)比(HR),各檢驗(yàn)效應(yīng)量水準(zhǔn)采用95%可信區(qū)間(confidence interval,CI)表示。繪制結(jié)果森林圖和漏斗圖并采用Egger線(xiàn)性回歸法和Begg秩相關(guān)檢驗(yàn)法定量分析發(fā)表偏倚來(lái)驗(yàn)證是否有發(fā)表偏倚,假若漏斗圖不對(duì)稱(chēng)和(或)Egger線(xiàn)性回歸法中的P0.1時(shí),表明可能存在發(fā)表偏倚。結(jié)果:最終納入18篇文獻(xiàn)共4394名結(jié)直腸癌癌患者,其中15篇文獻(xiàn)涉及的是組織中miRNA-21與結(jié)直腸癌預(yù)后關(guān)系,3篇將血液中miRNA-21作為樣本來(lái)研究;有7篇文獻(xiàn)提供了miRNA-21與DFS之間的關(guān)系,13篇文獻(xiàn)給出了miRNA-21與OS之間的關(guān)系。此外,Oue和Schetter分別報(bào)道了兩組獨(dú)立樣本中miRNA-21與OS之間的關(guān)系。Meta分析研究結(jié)果顯示1、在10項(xiàng)涉及結(jié)直腸癌患者組織中miRNA-21的表達(dá)與OS之間關(guān)系的研究中,合并后的效應(yīng)量HR=2.57,95%CI為(2.11,3.14),P0.00001,差異有統(tǒng)計(jì)學(xué)意義。95%CI不包含1,且合并HR1,提示結(jié)直腸癌患者組織中過(guò)表達(dá)的miRNA-21與術(shù)后不良的總生存期有顯著相關(guān)性,其術(shù)后具有較短總生存期的危險(xiǎn)是miRNA-21無(wú)過(guò)表達(dá)患者的2.57倍,說(shuō)明組織中miRNA-21過(guò)表達(dá)的結(jié)直腸癌患者預(yù)后欠佳,miRNA-21是結(jié)直腸癌患者預(yù)后的不良因素;2、在分析結(jié)直腸癌患者組織中miRNA-21的表達(dá)與DFS之間的關(guān)系時(shí),共納入7項(xiàng)研究,合并后的效應(yīng)量HR=1.49,95%CI為(1.33,1.68),P0.00001。95%CI不包含1,且合并HR1,提示組織中miRNA-21過(guò)表達(dá)的結(jié)直腸癌患者具有較短的無(wú)病生存期,其術(shù)后具有較短無(wú)病生存期的危險(xiǎn)是miRNA-21無(wú)過(guò)表達(dá)患者的1.49倍,說(shuō)明miRNA-21是結(jié)直腸癌患者預(yù)后的不良因素;3、此次僅有3項(xiàng)研究涉及了結(jié)直腸癌患者血液中miRNA-21的表達(dá)與其預(yù)后之間的關(guān)系,該3項(xiàng)研究報(bào)道均與OS有關(guān),且異質(zhì)性較大,采取隨機(jī)效應(yīng)模型,合并后的效應(yīng)量HR=1.33,95%CI值為(0.44,4.02),P=0.61,差異無(wú)統(tǒng)計(jì)學(xué)意義。提示在結(jié)直腸癌患者的血液中過(guò)表達(dá)的miRNA-21與其術(shù)后總的生存期無(wú)明顯相關(guān)性,即在血液中miRNA-21呈過(guò)表達(dá)水平的結(jié)直腸癌患者中,其術(shù)后總的生存期并不一定短。結(jié)論:1、結(jié)直腸癌患者的預(yù)后受多種因素的影響,其中miRNA-21的過(guò)表達(dá)提示結(jié)直腸癌預(yù)后不良;2、miRNA-21可作為未來(lái)結(jié)直腸癌治療研究的一個(gè)新方向,為結(jié)直腸癌的靶向治療提供了一個(gè)潛在靶點(diǎn);3、本研究不能完全避免偏倚的存在,尚需更多高質(zhì)量臨床研究來(lái)進(jìn)一步驗(yàn)證該研究結(jié)果。
[Abstract]:Objective: colorectal cancer is one of the common malignant tumor of the digestive tract, and its prognosis is affected by many factors. The influence of miRNA-21 in the prognosis of colorectal cancer patients is still controversial. This study mainly uses evidence-based medicine to provide evidence for clinical diagnosis and treatment by meta analysis of the relationship between miRNA-21 and the prognosis of colorectal cancer patients. Medical evidence. Methods: according to the type of the research, the object of research and the purpose of the study, the strict document inclusion and exclusion criteria, the detailed retrieval strategy, the PubMed, EBSCO, EMBASE full text database, the Cochrane library, Medline, the full text database of Chinese academic periodicals (CNKI), the Wanfang database and the scientific citation were retrieved through computer system. The index database, the Chinese biomedical literature database, the database of the Chongqing VIP Chinese sci-tech journal, and other databases were retrieved from the date of the establishment of the database to 03 months of 2017. In order to improve the recall, all the related references were traced. The relevant literature included in Newcastle - After the quality evaluation of the The Newcastle-Ottawa Scale (NOS), we set up the Excel form to collect the relevant data, and use the Revman5.3 software and Stata12.0 software provided by the international Cochrane cooperation network to analyze the extracted data, and the effect of survival analysis usually uses the risk ratio (HR), each test effect amount of water is water. The 95% confidence interval (confidence interval, CI) is used. The result forest map and the funnel plot are drawn and the Egger linear regression method and the Begg rank correlation test are used to quantify the publication bias to verify whether there is a publication bias. If the funnel map asymmetry and (or) the (or) Egger linear regression method are P0.1, there may be a publication bias. Result: in the final 18 literature, 4394 patients with colorectal cancer were included, 15 of which were related to the relationship between miRNA-21 and the prognosis of colorectal cancer, and 3 were used to study the miRNA-21 in the blood; 7 documents provided the relationship between miRNA-21 and DFS, and 13 articles presented the relationship between miRNA-21 and OS. In addition, Oue and Schett Er reported the relationship between miRNA-21 and OS in two groups of independent samples. The results of.Meta analysis showed 1. In the study of the relationship between the expression of miRNA-21 and OS in the 10 colorectal cancer patients, the combined effect HR=2.57,95%CI was (2.11,3.14), P0.00001, the difference was statistically significant and.95%CI did not contain 1, and HR1, It is suggested that the overexpressed miRNA-21 in the tissues of the colorectal cancer patients has a significant correlation with the poor total survival period. The risk of short total survival after the operation is 2.57 times as high as that of the patients without overexpression of miRNA-21. It indicates that the prognosis of colorectal cancer patients with miRNA-21 overexpression in the tissue is poor and miRNA-21 is a bad cause of the prognosis of colorectal cancer patients. 2, in the analysis of the relationship between miRNA-21 expression and DFS in colorectal cancer patients, 7 studies were included. The combined effect of HR=1.49,95%CI was (1.33,1.68), P0.00001.95%CI did not contain 1, and HR1 was combined, suggesting that colorectal cancer patients with miRNA-21 overexpression in the tissue have a shorter disease-free survival and a shorter postoperative period. The risk of the disease was 1.49 times the risk of miRNA-21 without overexpression, indicating that miRNA-21 was an adverse factor in the prognosis of colorectal cancer patients. 3, only 3 studies involved the relationship between the expression of miRNA-21 in the blood of the rectal cancer patients and the prognosis of the prognosis. The 3 studies were all related to OS, and the heterogeneity was larger and took a random Xiao Yingmo. The HR=1.33,95%CI value of the combined effect was (0.44,4.02) and P=0.61, the difference was not statistically significant. It suggested that the overexpressed miRNA-21 in the blood of the patients with colorectal cancer had no significant correlation with the total survival, that is, the total survival of the patients with colorectal cancer in the blood of miRNA-21 in the blood was not necessarily short. Conclusions: 1, the prognosis of colorectal cancer patients is affected by many factors, and the overexpression of miRNA-21 suggests poor prognosis for colorectal cancer; 2, miRNA-21 can be a new direction for the future research of colorectal cancer, and provide a potential target for the targeted treatment of colorectal cancer; 3, this study can not completely avoid the existence of bias and still need more. High quality clinical studies are needed to further validate the findings.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R735.34
本文編號(hào)：2150332
[Abstract]:Objective: colorectal cancer is one of the common malignant tumor of the digestive tract, and its prognosis is affected by many factors. The influence of miRNA-21 in the prognosis of colorectal cancer patients is still controversial. This study mainly uses evidence-based medicine to provide evidence for clinical diagnosis and treatment by meta analysis of the relationship between miRNA-21 and the prognosis of colorectal cancer patients. Medical evidence. Methods: according to the type of the research, the object of research and the purpose of the study, the strict document inclusion and exclusion criteria, the detailed retrieval strategy, the PubMed, EBSCO, EMBASE full text database, the Cochrane library, Medline, the full text database of Chinese academic periodicals (CNKI), the Wanfang database and the scientific citation were retrieved through computer system. The index database, the Chinese biomedical literature database, the database of the Chongqing VIP Chinese sci-tech journal, and other databases were retrieved from the date of the establishment of the database to 03 months of 2017. In order to improve the recall, all the related references were traced. The relevant literature included in Newcastle - After the quality evaluation of the The Newcastle-Ottawa Scale (NOS), we set up the Excel form to collect the relevant data, and use the Revman5.3 software and Stata12.0 software provided by the international Cochrane cooperation network to analyze the extracted data, and the effect of survival analysis usually uses the risk ratio (HR), each test effect amount of water is water. The 95% confidence interval (confidence interval, CI) is used. The result forest map and the funnel plot are drawn and the Egger linear regression method and the Begg rank correlation test are used to quantify the publication bias to verify whether there is a publication bias. If the funnel map asymmetry and (or) the (or) Egger linear regression method are P0.1, there may be a publication bias. Result: in the final 18 literature, 4394 patients with colorectal cancer were included, 15 of which were related to the relationship between miRNA-21 and the prognosis of colorectal cancer, and 3 were used to study the miRNA-21 in the blood; 7 documents provided the relationship between miRNA-21 and DFS, and 13 articles presented the relationship between miRNA-21 and OS. In addition, Oue and Schett Er reported the relationship between miRNA-21 and OS in two groups of independent samples. The results of.Meta analysis showed 1. In the study of the relationship between the expression of miRNA-21 and OS in the 10 colorectal cancer patients, the combined effect HR=2.57,95%CI was (2.11,3.14), P0.00001, the difference was statistically significant and.95%CI did not contain 1, and HR1, It is suggested that the overexpressed miRNA-21 in the tissues of the colorectal cancer patients has a significant correlation with the poor total survival period. The risk of short total survival after the operation is 2.57 times as high as that of the patients without overexpression of miRNA-21. It indicates that the prognosis of colorectal cancer patients with miRNA-21 overexpression in the tissue is poor and miRNA-21 is a bad cause of the prognosis of colorectal cancer patients. 2, in the analysis of the relationship between miRNA-21 expression and DFS in colorectal cancer patients, 7 studies were included. The combined effect of HR=1.49,95%CI was (1.33,1.68), P0.00001.95%CI did not contain 1, and HR1 was combined, suggesting that colorectal cancer patients with miRNA-21 overexpression in the tissue have a shorter disease-free survival and a shorter postoperative period. The risk of the disease was 1.49 times the risk of miRNA-21 without overexpression, indicating that miRNA-21 was an adverse factor in the prognosis of colorectal cancer patients. 3, only 3 studies involved the relationship between the expression of miRNA-21 in the blood of the rectal cancer patients and the prognosis of the prognosis. The 3 studies were all related to OS, and the heterogeneity was larger and took a random Xiao Yingmo. The HR=1.33,95%CI value of the combined effect was (0.44,4.02) and P=0.61, the difference was not statistically significant. It suggested that the overexpressed miRNA-21 in the blood of the patients with colorectal cancer had no significant correlation with the total survival, that is, the total survival of the patients with colorectal cancer in the blood of miRNA-21 in the blood was not necessarily short. Conclusions: 1, the prognosis of colorectal cancer patients is affected by many factors, and the overexpression of miRNA-21 suggests poor prognosis for colorectal cancer; 2, miRNA-21 can be a new direction for the future research of colorectal cancer, and provide a potential target for the targeted treatment of colorectal cancer; 3, this study can not completely avoid the existence of bias and still need more. High quality clinical studies are needed to further validate the findings.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R735.34
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