中国普外基础与临床杂志

中国普外基础与临床杂志

自噬相关蛋白 Beclin-1 在胃癌患者中表达意义的 meta 分析

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目的 对自噬相关蛋白 Beclin-1 在胃癌组织中的表达及其与胃癌患者不同临床病理特征的相关性及其临床意义进行系统评价。 方法 计算机检索 Cochrane Library、Springer Link、Web of Science、Embase、PubMed、中国知网、万方、维普等数据库建库至 2018 年 6 月 1 日前公开发表的关于胃肿瘤组织中 Beclin-1 蛋白表达及其意义的研究,由 2 名研究者独立筛选和评价文献,提取相关数据后运用 Review Manager 5.3 及 Stata 15.0 软件进行 meta 分析。 结果 最终纳入 10 篇文献,共有胃癌患者 1 402 例。meta 分析结果显示,Beclin-1 蛋白表达阳性率在胃癌组织中明显低于非胃癌组织[OR=0.30,95% CI(0.13,0.72),P=0.007],其在胃癌 TNM 分期Ⅲ/Ⅳ期和有远处转移患者的胃癌组织中均明显低于Ⅰ/Ⅱ期者[OR=1.82,95% CI(1.03,3.20),P=0.04]和无远处转移者[OR=0.36,95% CI(0.20,0.63),P=0.000 4],其在胃癌组织中的表达与胃癌患者的性别、年龄及肿瘤大小均无关(P>0.05);对存在异质性较大者进一步进行亚组分析结果显示,Beclin-1 蛋白表达阳性率在有淋巴结转移、侵及浆膜层和低分化程度者的胃癌组织中均明显低于无淋巴结转移[OR=0.35,95% CI(0.22,0.57),P<0.000 1]、未侵及浆膜层组织[OR=0.56,95% CI(0.33,0.94),P=0.03]和中/高分化程度者[OR=0.29,95% CI(0.20,0.43),P<0.000 01]。 结论 自噬相关蛋白 Beclin-1 在胃癌组织中低表达且与肿瘤分期和远处转移有关,提示其可能不仅是胃癌发生的重要原因,也可能对胃癌的进展起调控作用。

Objective To systematically evaluate relationship between expression of autophagy-related protein Beclin-1 in gastric cancer and its clinicopathologic features and its clinical significances. Methods The research on the expression and significance of Beclin-1 protein in the gastric tumor tissues published from the database establishment to June 1, 2018 in the Cochrane Library, Springer Link, Web of Science, Embase, PubMed, CNKI, Wanfang, VIP, and other databases were searched. Two researchers independently screened and evaluated the literatures, extracted the relevant data, and conducted the meta-analysis using the Review Manager 5.3 and Stata 15.0 software. Results Finally, 10 articles were included, and there were 1 402 patients with gastric cancer. The meta-analysis showed that the positive rate of Beclin1 protein expression in the gastric cancer tissues was significantly lower than that in the non-gastric cancer tissues [OR=0.30, 95% CI (0.13, 0.72), P=0.007], which in the patients with TNM stage Ⅲ/Ⅳ and distant metastatic gastric cancer were significantly lower than those in the patients with stage Ⅰ/Ⅱ [OR=1.82, 95% CI (1.03, 3.20), P=0.04] and without distant metastasis [OR=0.36, 95% CI (0.20, 0.63), P=0.000 4], which were not associated with the gender, age, and tumor size of gastric cancer patients (P>0.05). For the studies of existed heterogeneity, further the subgroup analysis showed that the positive expression rates of Beclin-1 protein in the gastric cancer tissues was significantly lower than that in the non-gastric cancer tissues [OR=0.19, 95% CI (0.13, 0.29), P<0.000 01], which in the patients with lymph node metastasis, invasion of serosa, and poorly differentiated gastric cancer were significantly lower than those in the non-lymph node metastasis [OR=0.35, 95% CI (0.22, 0.57), P<0.000 1], non-invasion of serosa [OR=0.56, 95% CI (0.33, 0.94), P=0.03], and moderately/highly differentiated gastric cancer tissues [OR=0.29, 95% CI (0.20, 0.43), P<0.000 1]. Conclusions Low expression of Beclin-1 in gastric cancer tissues is related to stage and distant metastasis of gastric cancer. It is suggested that it might not only be an important cause of gastric cancer, but also play a regulatory role in progress of gastric cancer.

关键词: 自噬; Beclin-1; 胃癌; meta 分析

Key words: autophagy; Beclin-1; gastric cancer; meta-analysis

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