Prognostic value of DNA aneuploidy in gastric cancer: a meta-analysis of 3449 cases
Prognostic value of DNA aneuploidy in gastric cancer: a meta-analysis of 3449 cases
复制标题
DNA非整倍体在胃癌中的预后价值：3449例病例的荟萃分析
DOI：
10.1186/s12885-019-5869-9
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发表时间：
2019-07-02
期刊：
影响因子：
3.8
通讯作者：
Sun，Guoping
中科院分区：
文献类型：
--
作者：
Xu，Jing;Zhu，Ruolin;Sun，Guoping
背景DNA非整倍体在临床上引起了越来越多的关注。然而，它在胃癌患者中的预后价值仍然存在争议。本Meta分析旨在探讨DNA倍体状态对胃癌患者生存的影响。方法应用PubMed和Web of Science数据库检索相关文献。分析DNA异倍体与胃癌分期、侵袭深度(T)、淋巴结转移(N)、远处转移(M)、分化程度(G)、肿瘤类型(Lauren分级)及总生存率(OS)的关系。风险比(HR)和相应的95%可信区间(CI)是从每一篇文章中仔细收集的，OS是与HRs一起提供的。用风险比(RR)和95%可信区间(CI)分析DNA非整倍体与各性状的关系。使用P<； 0.0 5建立显著性。结果经过仔细筛选，有25篇研究符合进一步分析的条件，共3449例。非整倍体患者有较高的分期风险(III-IV期与I-II期，RR = 1.23；95%CI，1.07~1.42；P= 0.003)、淋巴结转移(N+与N-：RR = 1.43；95%CI，1.12~1.82，P= 0.004)和肠道肿瘤类型(肠型与弥漫型：RR = 1.45；95%CI，1.02~2.06；P= 0.04)。DNA异倍体与肿瘤分化程度呈负相关。而非整倍体与远处转移(P= 0.42)和肿瘤侵袭深度(P= 0.86)无关。在总体生存方面，非整倍体肿瘤与所有患者的生存不良有关(P<； 0.00001)。结论异倍体是胃癌患者的一个重要预测指标，可作为胃癌进一步分类的潜在生物标志物。
BackgroundDNA aneuploidy has attracted growing interest in clinical practice. Nevertheless, its prognostic value in gastric cancer patients remains controversial. This meta-analysis aims to explore the impact of DNA ploidy status on the survival of gastric cancer patients.MethodsWe used PubMed and Web of Science databases to retrieve relevant articles. The correlation between DNA aneuploidy and the clinicopathological features of gastric cancer, such as stage, depth of invasion (T), lymph node metastasis (N), distant metastasis (M), differentiation (G), tumor types (Lauren classification) and overall survival (OS) were evaluated. Hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were collected carefully from each article OS was presented with HRs. The relationships between DNA aneuploidy and each characteristic were analyzed using risk ratios (RR) and a 95% confidence interval (CI). Significance was established usingP< 0.05. Funnel plot was conducted to detect the publication bias.ResultsAfter careful selection, 25 studies involving 3449 cases were eligible for further analyses. Patients with DNA aneuploidy were considered at risk of more advanced stages (stage III-IV vs. stages I-II, RR = 1.23; 95% CI, 1.07 to 1.42;P= 0.003), lymph node metastasis (N+ vs. N-: RR = 1.43; 95% CI, 1.12 to 1.82,P= 0.004), and intestinal tumor type (intestinal vs. diffuse: RR = 1.45; 95% CI, 1.02 to 2.06;P= 0.04). And an adverse relation was observed between DNA aneuploidy and tumor differentiation. While no association was found between DNA aneuploidy and distant metastasis (P= 0.42) nor depth of tumor invasion (P= 0.86). Regarding overall survival, aneuploid tumors were associated with worse survival in all patients (P< 0.00001).ConclusionsWe found that DNA aneuploidy was an important predictor for gastric cancer patients, and should be used as a potential biomarker for further classification in gastric cancer.