背景:Pim-1在癌组织中过表达,在癌变中起着至关重要的作用。然而,其在癌症中的临床意义尚未通过荟萃分析得到充分证实,尤其是与预后和临床病理特征有关。
方法:四个数据库,PubMed,Embase,科克伦图书馆,和WebofScience,被搜查了。根据纳入和排除标准进行文献筛选和数据提取。采用Newcastle-Ottawa量表对纳入文献进行质量评价,采用STATA和ReviewManager软件进行数据分析。
结果:最终纳入了15篇文章进行荟萃分析,涉及1651名患者。效应-大小汇集分析显示高Pim-1与低总生存期(OS)相关(HR1.68[95%CI1.17-2.40],P=.004)和无病生存率(DFS)(HR2.15[95CI1.15-4.01],P=.000)。亚组分析表明,Pim-1的检测技术是异质性的主要来源,2篇文献使用定量聚合酶链反应(qPCR)检测Pim-1mRNA具有较高的同质性(I2=.0%,P=.321)在操作系统中。另外13项应用免疫组织化学(IHC)检测Pim-1蛋白的研究具有显著的异质性(I2=82.2%,P=.000;I2=92%,P=.000)在OS和DFS中,分别,进一步的分析表明,种族,样本量,组织病理学起源被认为是影响其异质性的主要因素。此外,高Pim-1与淋巴结转移相关(OR1.40[95%CI1.02-1.92],P=.04),远处转移(OR2.69[95CI1.67-4.35],P<.0001),和临床III-IV期(OR.7[95%CI.50-.96,P=.03)。敏感性分析表明,每种效应大小的合并结果稳定可靠,在所有纳入的文章中没有显著的发表偏倚(P=.138)。
结论:高Pim-1不仅可以预测癌症的不良OS和DFS,还有助于推断肿瘤转移的恶性临床特点。Pim-1可能是早期诊断的潜在和有希望的生物标志物。肿瘤的预后分析和靶向治疗。
BACKGROUND: Pim-1 is overexpressed in cancer tissues and plays a vital role in carcinogenesis. However, its clinical significance in cancers is not fully verified by meta-analysis, especially in relation to prognosis and clinicopathological features.
METHODS: Four databases, PubMed, Embase, Cochrane Library, and Web of Science, were searched. Literature screening and data extraction according to the inclusion and exclusion criteria. The quality of the included literatures was evaluated using the Newcastle-Ottawa scale and the data analysis was performed using STATA and Review Manager software.
RESULTS: 15 articles were finally included for meta-analysis, involving 1651 patients. Effect-size pooling analysis showed that high Pim-1 was related to poor overall survival (OS) (HR 1.68 [95% CI 1.17-2.40], P = .004) and disease-free survival (DFS) (HR 2.15 [95 %CI 1.15-4.01], P = .000). Subgroup analysis indicated that the detection techniques of Pim-1 were the main sources of heterogeneity, and 2 literatures using quantitative polymerase chain reaction (qPCR) for Pim-1mRNA had high homogeneity (I2 = .0%, P = .321) in OS. Another 13 studies that applied immunohistochemistry (IHC) for Pim-1 protein had significant heterogeneity (I2=82.2%, P = .000; I2=92%, P = .000) in OS and DFS, respectively, and further analysis demonstrated that ethnicity, sample size, and histopathological origin were considered to be the main factors affecting their heterogeneity. In addition, high Pim-1 was associated with lymph node metastasis (OR 1.40 [95% CI 1.02-1.92], P = .04), distant metastasis (OR 2.69 [95%CI 1.67-4.35], P < .0001), and clinical stage III-IV (OR .7 [95% CI .50-.96, P = .03). Sensitivity analysis suggested that the pooled results of each effect-size were stable and reliable, and there was no significant publication bias (P = .138) in all included articles.
CONCLUSIONS: High Pim-1 can not only predict poor OS and DFS of cancer, but also help to infer the malignant clinical characteristics of tumor metastasis. Pim-1 may be a potential and promising biomarker for early diagnosis, prognostic analysis and targeted therapy of tumors.