背景:调查FBXW7突变和/或表达的临床意义的各种研究在结直肠癌(CRC)患者中产生了不确定的结果。因此,本荟萃分析总结了以前的证据,并评估了临床意义,包括预后作用,FBXW7在CRC中的地位。
方法:通过搜索PubMed的数据库进行荟萃分析,中国国家知识基础设施(CNKI),万方数据,WebofScience,Embase,和WebofScience。计算汇总比值比(ORs)和风险比(HRs)以及相应的95%置信区间(CIs),以评估FBXW7状态与CRC临床病理特征和生存率之间的关系。分别。
结果:涉及4199名患者的10项研究符合纳入标准,并纳入我们的荟萃分析。FBXW7突变/低表达与晚期T分期(OR=0.44,95%CI:0.27-0.74,P<0.01)和淋巴结转移(OR=1.88,95%CI:1.40-2.53,P<0.01)明显相关。但与其他参数无关。进一步研究发现FBXW7突变/低表达预测OS差(HR=1.25,95%CI:1.06-1.47,P<0.01),而非CRC中的DFS(HR=1.04,95%CI:0.60-1.82,P=0.88)。亚组分析发现,在2009年后招募的队列中,FBXW7状态与OS明显相关(HR=1.32,95%CI:1.17-1.50,P<0.01)。来自东亚(HR=1.27,95%CI:1.04-1.55,P=0.02),免疫组化/qRT-PCR检测(HR=1.39,95%CI:1.22-1.59,P<0.01),多因素分析(HR=1.47,95%CI:1.25-1.74,P<0.01)。
结论:这项研究表明FBXW7状态,特别是表达水平,与OS关联,但不与CRC中的DFS关联。FBXW7表达水平可作为CRC的预后生物标志物。
BACKGROUND: Various studies investigating the clinical significance of
FBXW7 mutation and/or expression have yielded inconclusive results in colorectal cancer (CRC) patients. Therefore, the present meta-analysis summarizes previous evidence and evaluates the clinical significance, including the prognostic role, of FBXW7 status in CRCs.
METHODS: The meta-analysis was conducted by searching the databases of PubMed, China National Knowledge Infrastructure (CNKI), WANFANG data, Web of Science, Embase, and Web of Science. Pooled odds ratios (ORs) and hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated to assess the relationships between FBXW7 status and clinicopathological features and survival in CRC, respectively.
RESULTS: Ten studies involving 4199 patients met the inclusion criteria and included in our meta-analysis.
FBXW7 mutation/low expression was obviously correlated with advanced T stage (OR = 0.44, 95% CI: 0.27-0.74, P < 0.01) and lymph node metastasis (OR = 1.88, 95% CI: 1.40-2.53, P < 0.01), but was not associated with other parameters. Further investigation found that
FBXW7 mutation/low expression predicted poor OS (HR = 1.25, 95% CI: 1.06-1.47, P < 0.01), but not DFS in CRC (HR = 1.04, 95% CI: 0.60-1.82, P = 0.88). Subgroup analysis found that
FBXW7 status was obviously correlated with OS in cohorts recruited after 2009 (HR = 1.32, 95% CI: 1.17-1.50, P < 0.01), from eastern Asia (HR = 1.27, 95% CI: 1.04-1.55, P = 0.02), detected by immunohistochemistry/qRT-PCR (HR = 1.39, 95% CI: 1.22-1.59, P < 0.01), and analysed with multivariate method (HR = 1.47, 95% CI: 1.25-1.74, P < 0.01).
CONCLUSIONS: This study indicates that FBXW7 status, expression level especially, is associated with OS but not DFS in CRC.
FBXW7 expression level may function as a prognostic biomarker in CRC.