METHODS: A broad, comprehensive, and reproducible search with methodological rigor was conducted for study selection using the ROBINS-I and GRADEpro protocols and appropriate combinations of keywords.
RESULTS: A total of 25 studies were selected: six with a complete classification similar to TCGA and 19 with a distinction between MSI-H and EBV+. The application of meta-analysis calculations reinforces the prevalence of positive Epstein-Barr adenocarcinomas in males and high microsatellite instability in females, with a high level of certainty of evidence and low risk of bias in the analyzed studies due to the rigorous methods used.
CONCLUSIONS: The molecular classification proposed by TCGA shows limited dissemination, with MSI-H and EBV+ subtypes being the most researched, probably due to the benefit of the association with immunotherapies. However, the subclassification cannot be restricted to less than a quarter of the cases, and improvements in this aspect are urgent for the construction of knowledge on this important topic of global health.
方法:广泛,全面,使用ROBINS-I和GRADepro方案以及适当的关键词组合,进行了方法学严谨的可重复搜索,以进行研究选择。
结果:总共选择了25项研究:6项具有与TCGA相似的完整分类,19项具有MSI-H和EBV+之间的区别。荟萃分析计算的应用加强了男性中Epstein-Barr腺癌阳性和女性中微卫星高度不稳定的患病率,由于使用了严格的方法,在分析的研究中具有高度的证据确定性和低偏倚风险。
结论:TCGA提出的分子分类显示传播有限,MSI-H和EBV+亚型是研究最多的,可能是由于与免疫疗法相关的好处。然而,子分类不能限于少于四分之一的案件,这方面的改进对于建立关于全球健康这一重要主题的知识是紧迫的。